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Gee, I don't know... maybe taking advice from people you don't know on the

internet, or basing a diet plan based on what it did to rats might be

considered extreme.

We have precious little experience with how energy restriction affects the

human body. Today's extreme practitioners are pioneers or fools depending

upon your point of view. If you are worried that perhaps you are a little

too close to the edge maybe you are, who knows. I don't.

If you want to do it, at least keep decent test documentation so the rest of

us can learn from your pioneering (or folly).

JR

-----Original Message-----

From: uptownguy34 [mailto:uptownguy34@...]

Sent: Monday, October 25, 2004 4:54 PM

Subject: [ ] What is extreme CR?

People often refer to " extremism " on this list, and " extreme CR "

or " extreme CRON " is typically condemned. Still, I'm not sure what

this means.

Is getting a very low level of calories " extreme CR " ? If so, where's

the cutoff point? Would it be 1,500 for men? 1,000 for women?

Wouldn't it have to depend on your height and weight, along with the

rate at which you typically lose weight?

Is eliminating a whole food group " extreme CR " ? If so, then are all

vegans and vegetarians on this list doing " extreme CR " ? Do we really

want to label vegetarians " extremists " ? I wouldn't. (Note that I

myself will eat almost anything, with the exception of things I

simply can't stomach or products containing trans-fats or too much

saturated fat. The quantity of " borderline " items I consume depends

on my assessment of how detrimental they could be to my health.)

Besides, CR (or CRON, if you prefer) is not, in my understanding of

it, a prescriptive diet. You create your own diet on the basis of

principles of optimal or at least adequate nutrition, and you lower

your calorie intake by an amount you determine. Naturally, it's best

not to give your body a shock by cutting your calories by 50 percent

overnight.

Is having a very low BMI an automatic determiner of " extreme CR " ?

Well, I can think of one individual--who shall remain unnamed--who

has, at times, been used on this list as an example of extremism and

who does indeed have a very low BMI. But what is someone who begins

CR with a low BMI to do, especially if that person truly believes

that CR will lead to greater health and longevity? Just give up on

the idea entirely, because CR will lead to an even lower BMI? That

doesn't seem a reasonable recommendation.

Is pushing CR to the point of doing damage to one's health what you

would call " extreme CR " ? That sounds more reasonable, but one

plausible explanation is that anyone who does so has simply

practiced CR badly and may since have recognized the error of his or

her ways. It's a tricky thing, after all. Why else would there be so

much debate about the benefits of fish, grains, and ALA, just to

cite a few examples, if " optimal nutrition " were a clear-cut issue?

It is not. The general outlines are more or less clear, but much

remains to be learned, as we all know. Therefore, it is absolutely

understandable that one may do damage to one's health in the process

of doing CR--even without intending to push things to extremes. I am

aware of a number of instances of this, and it's something that all

CR novices should be aware of.

I suppose I might consider the last point to be an example of

extreme CR if an individual pushed things to the point of serious

health damage and stubbornly refused to change. Still, it might be

more accurate to refer to such practices as " eating disorders " or,

as the case may be, " anorexia. "

So what do you think? Personally, I wonder whether my own CR would

be considered " extreme " by some on your list--not that I would feel

insulted, mind you.

I'll be interested to read people's responses to this topic.

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Here's some of my definitions of " extremism " YMMV:

Six foot tall males weighing 115 pds or so.

Not being able to go on a family vacation without preparing/taking coolers

and coolers of CRONIE food.

Sampling high calorie/rich foods, then spitting out (the beginnings of

bulemia?). Done in secret, and hiding from family/friends.

Any extreme cutting of calories/behavior leading to anorexia/bulemia or an

eating disorder.

CRON becoming the entire " raison d'etre " for existing rather than doing CRON

to exist better/longer. Your entire life revolving around all things CRON.

Cutting out an entire food group such as all whole grains (unless you're

allergic) extreme.

Just a few real life examples. Like porn: I know it when I see it.

As mentioned, I could be wrong. In 100 years or so we'll find out

......unless some of us start dropping like flies before that........

on 10/25/2004 5:53 PM, uptownguy34 at uptownguy34@... wrote:

>

> People often refer to " extremism " on this list, and " extreme CR "

> or " extreme CRON " is typically condemned. Still, I'm not sure what

> this means.

>

> Is getting a very low level of calories " extreme CR " ? If so, where's

> the cutoff point? Would it be 1,500 for men? 1,000 for women?

> Wouldn't it have to depend on your height and weight, along with the

> rate at which you typically lose weight?

>

> Is eliminating a whole food group " extreme CR " ? If so, then are all

> vegans and vegetarians on this list doing " extreme CR " ? Do we really

> want to label vegetarians " extremists " ? I wouldn't. (Note that I

> myself will eat almost anything, with the exception of things I

> simply can't stomach or products containing trans-fats or too much

> saturated fat. The quantity of " borderline " items I consume depends

> on my assessment of how detrimental they could be to my health.)

> Besides, CR (or CRON, if you prefer) is not, in my understanding of

> it, a prescriptive diet. You create your own diet on the basis of

> principles of optimal or at least adequate nutrition, and you lower

> your calorie intake by an amount you determine. Naturally, it's best

> not to give your body a shock by cutting your calories by 50 percent

> overnight.

>

> Is having a very low BMI an automatic determiner of " extreme CR " ?

> Well, I can think of one individual--who shall remain unnamed--who

> has, at times, been used on this list as an example of extremism and

> who does indeed have a very low BMI. But what is someone who begins

> CR with a low BMI to do, especially if that person truly believes

> that CR will lead to greater health and longevity? Just give up on

> the idea entirely, because CR will lead to an even lower BMI? That

> doesn't seem a reasonable recommendation.

>

> Is pushing CR to the point of doing damage to one's health what you

> would call " extreme CR " ? That sounds more reasonable, but one

> plausible explanation is that anyone who does so has simply

> practiced CR badly and may since have recognized the error of his or

> her ways. It's a tricky thing, after all. Why else would there be so

> much debate about the benefits of fish, grains, and ALA, just to

> cite a few examples, if " optimal nutrition " were a clear-cut issue?

> It is not. The general outlines are more or less clear, but much

> remains to be learned, as we all know. Therefore, it is absolutely

> understandable that one may do damage to one's health in the process

> of doing CR--even without intending to push things to extremes. I am

> aware of a number of instances of this, and it's something that all

> CR novices should be aware of.

>

> I suppose I might consider the last point to be an example of

> extreme CR if an individual pushed things to the point of serious

> health damage and stubbornly refused to change. Still, it might be

> more accurate to refer to such practices as " eating disorders " or,

> as the case may be, " anorexia. "

>

> So what do you think? Personally, I wonder whether my own CR would

> be considered " extreme " by some on your list--not that I would feel

> insulted, mind you.

>

> I'll be interested to read people's responses to this topic.

>

>

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Like porn. I know it when I see it... but sometimes I have to watch it again

just to be sure :-)

JR

PS: in a hundred years, somebody else may know... I suspect I'll be out of

circulation.

-----Original Message-----

From: Francesca Skelton [mailto:fskelton@...]

Sent: Monday, October 25, 2004 6:27 PM

support group

Subject: Re: [ ] What is extreme CR?

Just a few real life examples. Like porn: I know it when I see it.

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Hi :

This is an issue that is of interest to me and I have made a couple

of minor attempts to sort it out in my mind without much success.

It seems to me that CR can be 'extreme' in two principal ways:

A) By cutting back much too quickly at the outset (your 50% drop in

caloric intake example) thereby losing weight much too fast and

perhaps causing serious problems of some kind. But I am not aware of

what those problems would be, beyond the obvious one of deficiencies

in some important nutrients. But that does not, imo, really qualify

as extremism, but rather just poor nutrition.

B) By dropping your BMI (or whatever measure you prefer) endpoint

too far. Below BMI = 18, perhaps; or below BF% = 7% for males; or

below WC/H = 0.42 for males; or ............. .

I submit that this is essentially identical to dropping your target

endpoint caloric intake too far. Since it is very probable that, for

each individual, every average long term caloric intake number will

be associated with its own BF%, BMI and WC/H numbers - with lower

intakes yielding lower numbers, obviously.

The solution to A) is dead easy. Lose weight at a rate of half a

pound a week. I have only a vague idea about what is appropriate in

case B). I am relying on the data (from WUSTL, largely) for those

healthy individuals who have been stabilized on CR for quite some

time. Right now I believe BF% is probably the best criterion for me

to use. My present plan is to drop it to 10% (as measured using the

US Navy technique), stabilize there and think about it for quite some

time. All the while, it goes without saying, getting at least the

RDA for all nutrients.

Also it has been mentioned here that in one particular mouse

experiment the extreme CRON mice lived less long than the control

mice. I sure would like to see that study to ascertain exactly in

what what way the implementation of CRON was extreme in that case.

Rodney.

>

> People often refer to " extremism " on this list, and " extreme CR "

> or " extreme CRON " is typically condemned. Still, I'm not sure what

> this means.

>

> Is getting a very low level of calories " extreme CR " ? If so,

where's

> the cutoff point? Would it be 1,500 for men? 1,000 for women?

> Wouldn't it have to depend on your height and weight, along with

the

> rate at which you typically lose weight?

>

> Is eliminating a whole food group " extreme CR " ? If so, then are all

> vegans and vegetarians on this list doing " extreme CR " ? Do we

really

> want to label vegetarians " extremists " ? I wouldn't. (Note that I

> myself will eat almost anything, with the exception of things I

> simply can't stomach or products containing trans-fats or too much

> saturated fat. The quantity of " borderline " items I consume depends

> on my assessment of how detrimental they could be to my health.)

> Besides, CR (or CRON, if you prefer) is not, in my understanding of

> it, a prescriptive diet. You create your own diet on the basis of

> principles of optimal or at least adequate nutrition, and you lower

> your calorie intake by an amount you determine. Naturally, it's

best

> not to give your body a shock by cutting your calories by 50

percent

> overnight.

>

> Is having a very low BMI an automatic determiner of " extreme CR " ?

> Well, I can think of one individual--who shall remain unnamed--who

> has, at times, been used on this list as an example of extremism

and

> who does indeed have a very low BMI. But what is someone who begins

> CR with a low BMI to do, especially if that person truly believes

> that CR will lead to greater health and longevity? Just give up on

> the idea entirely, because CR will lead to an even lower BMI? That

> doesn't seem a reasonable recommendation.

>

> Is pushing CR to the point of doing damage to one's health what you

> would call " extreme CR " ? That sounds more reasonable, but one

> plausible explanation is that anyone who does so has simply

> practiced CR badly and may since have recognized the error of his

or

> her ways. It's a tricky thing, after all. Why else would there be

so

> much debate about the benefits of fish, grains, and ALA, just to

> cite a few examples, if " optimal nutrition " were a clear-cut issue?

> It is not. The general outlines are more or less clear, but much

> remains to be learned, as we all know. Therefore, it is absolutely

> understandable that one may do damage to one's health in the

process

> of doing CR--even without intending to push things to extremes. I

am

> aware of a number of instances of this, and it's something that all

> CR novices should be aware of.

>

> I suppose I might consider the last point to be an example of

> extreme CR if an individual pushed things to the point of serious

> health damage and stubbornly refused to change. Still, it might be

> more accurate to refer to such practices as " eating disorders " or,

> as the case may be, " anorexia. "

>

> So what do you think? Personally, I wonder whether my own CR would

> be considered " extreme " by some on your list--not that I would feel

> insulted, mind you.

>

> I'll be interested to read people's responses to this topic.

>

>

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" Cutting out an entire food group such as all whole grains (unless

you're allergic) extreme. "

Do you consider cutting out meat extreme?

>

> >

> > People often refer to " extremism " on this list, and " extreme CR "

> > or " extreme CRON " is typically condemned. Still, I'm not sure what

> > this means.

> >

> > Is getting a very low level of calories " extreme CR " ? If so, where's

> > the cutoff point? Would it be 1,500 for men? 1,000 for women?

> > Wouldn't it have to depend on your height and weight, along with the

> > rate at which you typically lose weight?

> >

> > Is eliminating a whole food group " extreme CR " ? If so, then are all

> > vegans and vegetarians on this list doing " extreme CR " ? Do we really

> > want to label vegetarians " extremists " ? I wouldn't. (Note that I

> > myself will eat almost anything, with the exception of things I

> > simply can't stomach or products containing trans-fats or too much

> > saturated fat. The quantity of " borderline " items I consume depends

> > on my assessment of how detrimental they could be to my health.)

> > Besides, CR (or CRON, if you prefer) is not, in my understanding of

> > it, a prescriptive diet. You create your own diet on the basis of

> > principles of optimal or at least adequate nutrition, and you lower

> > your calorie intake by an amount you determine. Naturally, it's best

> > not to give your body a shock by cutting your calories by 50 percent

> > overnight.

> >

> > Is having a very low BMI an automatic determiner of " extreme CR " ?

> > Well, I can think of one individual--who shall remain unnamed--who

> > has, at times, been used on this list as an example of extremism and

> > who does indeed have a very low BMI. But what is someone who begins

> > CR with a low BMI to do, especially if that person truly believes

> > that CR will lead to greater health and longevity? Just give up on

> > the idea entirely, because CR will lead to an even lower BMI? That

> > doesn't seem a reasonable recommendation.

> >

> > Is pushing CR to the point of doing damage to one's health what you

> > would call " extreme CR " ? That sounds more reasonable, but one

> > plausible explanation is that anyone who does so has simply

> > practiced CR badly and may since have recognized the error of his or

> > her ways. It's a tricky thing, after all. Why else would there be so

> > much debate about the benefits of fish, grains, and ALA, just to

> > cite a few examples, if " optimal nutrition " were a clear-cut issue?

> > It is not. The general outlines are more or less clear, but much

> > remains to be learned, as we all know. Therefore, it is absolutely

> > understandable that one may do damage to one's health in the process

> > of doing CR--even without intending to push things to extremes. I am

> > aware of a number of instances of this, and it's something that all

> > CR novices should be aware of.

> >

> > I suppose I might consider the last point to be an example of

> > extreme CR if an individual pushed things to the point of serious

> > health damage and stubbornly refused to change. Still, it might be

> > more accurate to refer to such practices as " eating disorders " or,

> > as the case may be, " anorexia. "

> >

> > So what do you think? Personally, I wonder whether my own CR would

> > be considered " extreme " by some on your list--not that I would feel

> > insulted, mind you.

> >

> > I'll be interested to read people's responses to this topic.

> >

> >

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" You're asking the same question I'm asking, in essence. If cutting

out a whole food group is extreme, what about vegetarians?

Vegetarians don't eat meat, poultry, or fish. "

Personally I think extreme would be living off one protein source

predominantly (soy, whey, rice, wheat, meat, fish etc) and getting a

balance of proteins is best. So I go for, chicken/turkey 3 times

month, fish almost daily, goats milk kifer daily and would also like

to add a range of veg proteins (legumes, grains etc) when I work out

which suit me best (allergies and energy etc).

So I would ask the same question as before, where are the 90 year

old vegetarians, but this time there do seem to be some (is it the

hamish an american religious group who do well on lacto-ovo) - also

we do have Norman s books, he lived to around hundred and five

years (some say hundred and nine) after turning to a raw veg juices,

salads, fruits, eggs, butter, swiss cheese and fullfat cream and

nuts diet at the age of fifty (though looking at pictures of him and

reading his books I suspect a little (10% perhaps) calorie

restriction was also part of his life style. So at least here it

seems vegetarians can do very well on their lacto-ovo diet. - though

my money is still on the fish eaters to come out best. But saying

that, I really don't think a bit of red meat once a month could

possibly adversely effect life span or health, as CRONIES it would

be too small an issue.

richard ....

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Hi folks:

Well here is another criterion that might work to define what is

extreme.

A couple of years ago I emailed a prominent company that sells very

expensive cat food. I asked them if they would be kind enough to

send me, or provide references for, any literature they were aware of

that cats fed the food they produced were healthier, or lived longer,

than cats that ate the regular 'guaranteed fully nutritious', and

much less expensive, cat foods available in supermarkets.

Naturally they did not reply, which provided me with precisely the

answer I needed.

Since CRON is supposed to make people healthier and permit them a

longer life, might not extreme CRON be DEFINED AS any CRON-like

action which does, or appears likely to given the (currently

incomplete) information we have, reduce lifespan, or result in less

optimal health than that afforded by other, more 'moderate', versions

of CRON?

If veganism, or vegetarianism, or anti-grainism, or anti-

hydrogenationism, or excessively thinnism are shown to reduce the

benefits we think we are getting from CRON then by definition they

would be defined as extreme. And it doesn't matter a hoot whether

the reason for such eating habits is based on 'ethical'

considerations or some misguided religous principles. If there is

credible evidence they are less than optimal for health/lifespan then

they are inadvisable and therefore perhaps should be defined as

extreme.

But if they are shown to provide a greater benefit than more moderate

versions, then they cannot be defined as extreme.

Perhaps one could think of the benefits from CRON-like behaviours as

being in the shape of an inverted parabola. Benefits increase as one

moves from ad lib toward CRON and then increase more slowly as CRON

degree increases until a peak is reached. After the peak the degree

of benefit begins to decline, slowly at first and more rapidly as the

degree of extremism increases. Anywhere beyond the peak would be

defined as extreme. Just beyond the peak would be only somewhat

extreme.

Just trying to get to the bottom of what basis should be used to

define the term 'extreme'.

Of course our knowledge of these issues is far from complete at this

time. But that need not be a reason for such a definition to be

inappropriate, if it works well for other reasons.

Rodney.

> on 10/25/2004 5:53 PM, uptownguy34 at uptownguy34@y... wrote:

>

> >

> > People often refer to " extremism " on this list, and " extreme CR "

> > or " extreme CRON " is typically condemned. Still, I'm not sure what

> > this means.

> >

> > Is getting a very low level of calories " extreme CR " ? If so,

where's

> > the cutoff point? Would it be 1,500 for men? 1,000 for women?

> > Wouldn't it have to depend on your height and weight, along with

the

> > rate at which you typically lose weight?

> >

> > Is eliminating a whole food group " extreme CR " ? If so, then are

all

> > vegans and vegetarians on this list doing " extreme CR " ? Do we

really

> > want to label vegetarians " extremists " ? I wouldn't. (Note that I

> > myself will eat almost anything, with the exception of things I

> > simply can't stomach or products containing trans-fats or too much

> > saturated fat. The quantity of " borderline " items I consume

depends

> > on my assessment of how detrimental they could be to my health.)

> > Besides, CR (or CRON, if you prefer) is not, in my understanding

of

> > it, a prescriptive diet. You create your own diet on the basis of

> > principles of optimal or at least adequate nutrition, and you

lower

> > your calorie intake by an amount you determine. Naturally, it's

best

> > not to give your body a shock by cutting your calories by 50

percent

> > overnight.

> >

> > Is having a very low BMI an automatic determiner of " extreme CR " ?

> > Well, I can think of one individual--who shall remain unnamed--who

> > has, at times, been used on this list as an example of extremism

and

> > who does indeed have a very low BMI. But what is someone who

begins

> > CR with a low BMI to do, especially if that person truly believes

> > that CR will lead to greater health and longevity? Just give up on

> > the idea entirely, because CR will lead to an even lower BMI? That

> > doesn't seem a reasonable recommendation.

> >

> > Is pushing CR to the point of doing damage to one's health what

you

> > would call " extreme CR " ? That sounds more reasonable, but one

> > plausible explanation is that anyone who does so has simply

> > practiced CR badly and may since have recognized the error of his

or

> > her ways. It's a tricky thing, after all. Why else would there be

so

> > much debate about the benefits of fish, grains, and ALA, just to

> > cite a few examples, if " optimal nutrition " were a clear-cut

issue?

> > It is not. The general outlines are more or less clear, but much

> > remains to be learned, as we all know. Therefore, it is absolutely

> > understandable that one may do damage to one's health in the

process

> > of doing CR--even without intending to push things to extremes. I

am

> > aware of a number of instances of this, and it's something that

all

> > CR novices should be aware of.

> >

> > I suppose I might consider the last point to be an example of

> > extreme CR if an individual pushed things to the point of serious

> > health damage and stubbornly refused to change. Still, it might be

> > more accurate to refer to such practices as " eating disorders " or,

> > as the case may be, " anorexia. "

> >

> > So what do you think? Personally, I wonder whether my own CR would

> > be considered " extreme " by some on your list--not that I would

feel

> > insulted, mind you.

> >

> > I'll be interested to read people's responses to this topic.

> >

> >

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The " know it when I see it " argument is used universally. When you watch TV

and see starving children it's pretty obvious they're starving; when the doc

(or anyone) says: " Oh my you've lost too much weight " etc. So YOU may think

it subjective, but the rest of the world is very comfortable with it.

See my yesterday's post about vegetarianism and cutting out a whole food

group. I addressed that argument that principles, ethics and allergies are

not extremism IMO.

I agree with Apricot that you seem to be toying with us and trying to

provoke us.

on 10/26/2004 1:45 AM, ONeill at uptownguy34@... wrote:

> Hi, Francesca--

>

> The " I-know-it-when-I-see-it " argument makes me nervous. It seems a bit too

> subjective.

>

> If you see a six-foot tall male " weighing 115 pounds or so, " is that a cutoff

> point? That's a BMI roughly of 15.63. On the other hand, do you really mean " a

> very thin man " ? That seems a bit subjective also. For example, I've been

> called extremely thin by some of my friends, and one has even expressed shock

> at my thinness. However, I have a BMI above 19, and my doctor thinks I'm " in

> really good shape. " So when you say, " I know it when I see it, " I'm a bit

> skeptical.

>

> Is extreme CR something that has resulted in an eating disorder? I'm referring

> to your examples of bulimia and anorexia. These conditions have specific

> criteria and can be diagnosed. I would think they are different from CR per

> se, and I also imagine that 99 percent of us do not have an eating disorder.

> Though I may be wrong: it may be as low as 98 percent.

>

> I'm really not sure about your example of cutting out a whole food group.

> Vegetarians obviously come to mind. Also, many people on SAD have cut out at

> least 1 food group without thinking about it as such, just because of personal

> taste. My mother, for example, can't stand most dairy products, but she's not

> lactose intolerant. She will consume them from time to time, but she gets any

> dairy at all only on rare occasions. She's quite old and has no problems of

> bone mass.

>

> I suppose my real problem with the whole question is that since we tend to

> insist more on scientific judgments and criteria, the question of " extreme CR "

> seems a bit too undefined--unless there is a common definition I'm simply

> unaware of.

>

>

>

>

> Francesca Skelton <fskelton@...> wrote:

> Here's some of my definitions of " extremism " YMMV:

>

> Six foot tall males weighing 115 pds or so.

>

> Not being able to go on a family vacation without preparing/taking coolers

> and coolers of CRONIE food.

>

> Sampling high calorie/rich foods, then spitting out (the beginnings of

> bulemia?). Done in secret, and hiding from family/friends.

>

> Any extreme cutting of calories/behavior leading to anorexia/bulemia or an

> eating disorder.

>

> CRON becoming the entire " raison d'etre " for existing rather than doing CRON

> to exist better/longer. Your entire life revolving around all things CRON.

>

> Cutting out an entire food group such as all whole grains (unless you're

> allergic) extreme.

>

> Just a few real life examples. Like porn: I know it when I see it.

>

> As mentioned, I could be wrong. In 100 years or so we'll find out

> .....unless some of us start dropping like flies before that........

>

>

>

>

> on 10/25/2004 5:53 PM, uptownguy34 at uptownguy34@... wrote:

>

>>

>> People often refer to " extremism " on this list, and " extreme CR "

>> or " extreme CRON " is typically condemned. Still, I'm not sure what

>> this means.

>>

>> Is getting a very low level of calories " extreme CR " ? If so, where's

>> the cutoff point? Would it be 1,500 for men? 1,000 for women?

>> Wouldn't it have to depend on your height and weight, along with the

>> rate at which you typically lose weight?

>>

>> Is eliminating a whole food group " extreme CR " ? If so, then are all

>> vegans and vegetarians on this list doing " extreme CR " ? Do we really

>> want to label vegetarians " extremists " ? I wouldn't. (Note that I

>> myself will eat almost anything, with the exception of things I

>> simply can't stomach or products containing trans-fats or too much

>> saturated fat. The quantity of " borderline " items I consume depends

>> on my assessment of how detrimental they could be to my health.)

>> Besides, CR (or CRON, if you prefer) is not, in my understanding of

>> it, a prescriptive diet. You create your own diet on the basis of

>> principles of optimal or at least adequate nutrition, and you lower

>> your calorie intake by an amount you determine. Naturally, it's best

>> not to give your body a shock by cutting your calories by 50 percent

>> overnight.

>>

>> Is having a very low BMI an automatic determiner of " extreme CR " ?

>> Well, I can think of one individual--who shall remain unnamed--who

>> has, at times, been used on this list as an example of extremism and

>> who does indeed have a very low BMI. But what is someone who begins

>> CR with a low BMI to do, especially if that person truly believes

>> that CR will lead to greater health and longevity? Just give up on

>> the idea entirely, because CR will lead to an even lower BMI? That

>> doesn't seem a reasonable recommendation.

>>

>> Is pushing CR to the point of doing damage to one's health what you

>> would call " extreme CR " ? That sounds more reasonable, but one

>> plausible explanation is that anyone who does so has simply

>> practiced CR badly and may since have recognized the error of his or

>> her ways. It's a tricky thing, after all. Why else would there be so

>> much debate about the benefits of fish, grains, and ALA, just to

>> cite a few examples, if " optimal nutrition " were a clear-cut issue?

>> It is not. The general outlines are more or less clear, but much

>> remains to be learned, as we all know. Therefore, it is absolutely

>> understandable that one may do damage to one's health in the process

>> of doing CR--even without intending to push things to extremes. I am

>> aware of a number of instances of this, and it's something that all

>> CR novices should be aware of.

>>

>> I suppose I might consider the last point to be an example of

>> extreme CR if an individual pushed things to the point of serious

>> health damage and stubbornly refused to change. Still, it might be

>> more accurate to refer to such practices as " eating disorders " or,

>> as the case may be, " anorexia. "

>>

>> So what do you think? Personally, I wonder whether my own CR would

>> be considered " extreme " by some on your list--not that I would feel

>> insulted, mind you.

>>

>> I'll be interested to read people's responses to this topic.

>>

>>

>

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" However, I have a BMI above 19, and my doctor thinks I'm " in really

good shape. " > so why worry about weight, just look at you calories,

they are the factor, you can be as thin as a rake on 3000 cals if

you are very active (but CR is all about Calories and Optimum

Nutrition, weight will sort itself out and if it gets to low your

doctor will say).

The " I-know-it-when-I-see-it " argument makes me nervous. It seems a

bit too subjective.

It may be subjective, but if you come into calorie restriction

without anorexic tendencies then you will know what slim means, what

thin means and what anorexic means. Looking at these five pictures

of Dean P as he calorie restricted over a few years. There is a

point (which will vary with individuals) at which Deans body is

enough for them and they wish to go no further. To me dean seemed to

start at a good weight/look, then got thin then ended up looking

anorexic (but I am not saying he is anorexic, but I certainly would

not want to look like that, it looks too fragile). He eats around

1800 cals a day (and is total vegan having recently given up whey)

http://deanpomerleau.tripod.com/pictures/index.htm

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I recall 135# 5'9" and I was skinny (subjective). Couldn't push a shovel into Texas clay (real).

Couldn't play football (real). Too short for the basketball team (real). I could figure out how to move a used railroad tie a mile, by myself.

It didn't bother the prettiest girl in the school (that's what's important).

And one of those articles I posted recently showed a "good" BMI between 20 - 24, as I recall. I have a "gut" feeling the ideal BMI may change with chronological age. I don't know the whole purpose of adipose tissue, yet. Like it may be a good place to isolate bad stuff.

Regards.

----- Original Message -----

From: Francesca Skelton

support group

Sent: Tuesday, October 26, 2004 9:27 AM

Subject: FW: [ ] What is extreme CR?

Here's a post by you using the same "subjective" method: /message/15512To further elaborate: My own opinion is that a BMI under 18 presents aslippery slope. Or a daily calorie count under 1000 is cause for greatalarm (Walford warned against eating less than 1000 cal a day). And in somecases, eating over 1000 cal could still be much too little, esp if losingtoo much weight and body fat/mass. You could wind up losing heart muscle andother vitals. As Citpeks has posted, we need a certain % of bodyfat for proper functioningof the brain and for reserve in case we DO get sick. No reserves couldequal death if some accident or illness strikes.We have no way of knowing how many CRONIES have eating disorders. But evenif only 2% as you suggest, that's too many. Perhaps our many warnings onthis list is keeping the number from going higher._____________________________Francesca wrote:

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Hi :

Many thanks for that information about Dean Pomerleau. Very

interesting.

Perhaps I am confused. But I thought Dean was the example quoted

here as being six feet tall and 115 pounds?????

Well those data provide both weight and BMI so you can calculate his

height. If those data are correct he is nowhere near six feet tall.

Quite the contrary, he is quite short, at 5' 8.5 " . So it is no

longer obvious to me that he is excessively thin.

Also very interesting from his data is that he lost weight at a rate

of one pound per week for the first seven months - not drastically

rapid - and thereafter at a minuscule quarter of a pound per week.

In other words a caloric deficit of the gigantic (NOT) amount of 125

calories per day!

So he has hardly been extreme in his RATE of weight loss.

As for whether his absolute 'final stabilized weight' of whatever it

is - 115 pounds is claimed - is extreme, I don't know. But take a

look at his picture after he had dropped from 170 pounds to 126. You

can only barely make out any ribs. So in my opinion 126 pounds, BMI

= 18.9, is not excessively thin for him either. But he appears to be

a lot thinner at only three pounds lighter, 123 pounds, BMI = 18.5,

but the lighting is different. I wonder if that has made a

difference. If we had a picture of him at 115 pounds I would

probably think that was too low. Except we really do not know yet

what constitutes the ideal degree of restriction. So we each have to

come to our own conclusions about what we think (hope) is appropriate

for us.

Of course underdoing CRON seems very unlikely to do any harm.

Overdoing it, whatever that means, presumably could. Perhaps we

could learn something from concentration camp survivors. Although

they, of course, were not only restricted calorically, but also must

have been dramatically deficient in many important nutrients.

Luigi Fontana's WUSTL subjects seemed to be pretty healthy by most

standard tests. They had body fat of six-point-something percent,

and BMIs averaging eighteen-point-something I believe (not certain

the latter is correct, I cannot access my copy of the study).

All fwiw

Rodney.

>

> " However, I have a BMI above 19, and my doctor thinks I'm " in

really

> good shape. " > so why worry about weight, just look at you

calories,

> they are the factor, you can be as thin as a rake on 3000 cals if

> you are very active (but CR is all about Calories and Optimum

> Nutrition, weight will sort itself out and if it gets to low your

> doctor will say).

>

> The " I-know-it-when-I-see-it " argument makes me nervous. It seems a

> bit too subjective.

>

> It may be subjective, but if you come into calorie restriction

> without anorexic tendencies then you will know what slim means,

what

> thin means and what anorexic means. Looking at these five pictures

> of Dean P as he calorie restricted over a few years. There is a

> point (which will vary with individuals) at which Deans body is

> enough for them and they wish to go no further. To me dean seemed

to

> start at a good weight/look, then got thin then ended up looking

> anorexic (but I am not saying he is anorexic, but I certainly would

> not want to look like that, it looks too fragile). He eats around

> 1800 cals a day (and is total vegan having recently given up whey)

>

> http://deanpomerleau.tripod.com/pictures/index.htm

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Rodney, your thots mirror mine.. I've seen his photos before the first

thing I noticed were his ribs (i think a good rough indication of

leaness), he looks like he still has fat around his ribs.

You know I never really liked " BMI " because it has lots of built in

error.. not precise enuf IMO. For instance, look at Mike Tyson (the

boxer), here is his stats: http://brevheart.tripod.com/taleofthetape.htm

he weighs 218 @5'11' .. BUT HIS WRIST GIRTH IS EIGHT INCHES! The guy

has huge bone thickness. (And musculature. he looks like a

'mesomorph') But BMI doesn't care.. his is 30.4 !! Would call him

overweight??

Now, *I* am 5'11 " but @ 218 I would be FAT! Very fat!

I don't trust BMI.. I like PERCENT BODY FAT much better. What better

guide than the actual % of fat on your physique???!

> >

> > " However, I have a BMI above 19, and my doctor thinks I'm " in

> really

> > good shape. " > so why worry about weight, just look at you

> calories,

> > they are the factor, you can be as thin as a rake on 3000 cals if

> > you are very active (but CR is all about Calories and Optimum

> > Nutrition, weight will sort itself out and if it gets to low your

> > doctor will say).

> >

> > The " I-know-it-when-I-see-it " argument makes me nervous. It seems a

> > bit too subjective.

> >

> > It may be subjective, but if you come into calorie restriction

> > without anorexic tendencies then you will know what slim means,

> what

> > thin means and what anorexic means. Looking at these five pictures

> > of Dean P as he calorie restricted over a few years. There is a

> > point (which will vary with individuals) at which Deans body is

> > enough for them and they wish to go no further. To me dean seemed

> to

> > start at a good weight/look, then got thin then ended up looking

> > anorexic (but I am not saying he is anorexic, but I certainly would

> > not want to look like that, it looks too fragile). He eats around

> > 1800 cals a day (and is total vegan having recently given up whey)

> >

> > http://deanpomerleau.tripod.com/pictures/index.htm

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Hi folks:

I see I was right. I *was* confused. Someone just informed me that

no one ever suggested Dean Pomerleau was six feet tall.

Rodney.

--- In , " Rodney " <perspect1111@y...>

wrote:

> Perhaps I am confused. But I thought Dean was the example quoted

> here as being six feet tall and 115 pounds?????

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Hi Freebird:

Yes. My impression is - subject to change without notice - that if

one has reason to suspect that one's bone mass or muscle volume is

above or below the norm, then BF% is likely to be a safer measure to

use to determine CR weight targets than BMI. Or at least it would be

if we knew where we are supposed to be aiming for. And if we can be

confident we can rely on the method for measurement of BF%.

Rodney.

> > >

> > > " However, I have a BMI above 19, and my doctor thinks I'm " in

> > really

> > > good shape. " > so why worry about weight, just look at you

> > calories,

> > > they are the factor, you can be as thin as a rake on 3000 cals

if

> > > you are very active (but CR is all about Calories and Optimum

> > > Nutrition, weight will sort itself out and if it gets to low

your

> > > doctor will say).

> > >

> > > The " I-know-it-when-I-see-it " argument makes me nervous. It

seems a

> > > bit too subjective.

> > >

> > > It may be subjective, but if you come into calorie restriction

> > > without anorexic tendencies then you will know what slim means,

> > what

> > > thin means and what anorexic means. Looking at these five

pictures

> > > of Dean P as he calorie restricted over a few years. There is a

> > > point (which will vary with individuals) at which Deans body is

> > > enough for them and they wish to go no further. To me dean

seemed

> > to

> > > start at a good weight/look, then got thin then ended up

looking

> > > anorexic (but I am not saying he is anorexic, but I certainly

would

> > > not want to look like that, it looks too fragile). He eats

around

> > > 1800 cals a day (and is total vegan having recently given up

whey)

> > >

> > > http://deanpomerleau.tripod.com/pictures/index.htm

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>

> >>>

> From: " uptownguy34 " <uptownguy34@y...>

> Date: Mon Oct 25, 2004 5:53 pm

> Subject: What is extreme CR?

> >>>

>

> There is a series of three papers by Vitousek, et. al, from

the

> department of psychology, University of Hawaii, that portray caloric

> restriction as an anorexic lifestyle called the " CR syndrome " . The

> authors say that Walford put a positive spin on food deprivation and

> understated the degree of hunger and deprivation in the Biosphere.

> The authors even used some of the postings on the

> calorierestriction.org web site as references to document the

reduced

> libido and other physical problems of CR practitioners. According

to

> the author, " To eating disorder (ED) specialists, severe caloric

> restriction (CR) is a symptomatic behaviour. When sustained for

years,

> it imposes grave consequences on the few troubled people who

persist. "

>

> What can we learn from this? 1) What you post can be used against

you

> in unexpected ways. 2) CR is viewed as something abnormal practiced

by

> people with some mental compulsion or disorder.

>

> Tony

>

> ===

>

> European Eating Disorders Review, 12, Issue 5 (September/October

2004)

> Caloric restriction for longevity: I. Paradigm, protocols

> and physiological findings in animal research (p 279-299)

> M. Vitousek, A. Gray, Kathleen M. Grubbs

>

> Caloric restriction for longevity: II - The systematic neglect of

> behavioural and psychological outcomes in animal research.

> M. Vitousek, Frederic P. Manke, A. Gray, Maren N.

> Vitousek, Eur. Eat. Disorders Rev. 12, 338–360 (2004)

>

> The case for semi-starvation (p 275-278)

> M. Vitousek, Published Online: 26 Aug 2004

Hi All,

M. Vitousek does throw a challenge to CRers in the below.

Note the references to the CR Society file archives for Dean P and

Sherm.

There is a huge amount of information that may be swamped by

presenting the three below pdfs in full, but the three-page overview

may somewhat suffice.

The pdfs are available as is the in press one below.

European Eating Disorders Review, 12, Issue 5 (September/October

2004)

Caloric restriction for longevity: I. Paradigm, protocols

and physiological findings in animal research (p 279-299)

M. Vitousek, A. Gray, Kathleen M. Grubbs

Published Online: 26 Aug 2004

DOI: 10.1002/erv.594, Full Text: PDF (Size: 192K)

... Across the CRL literature, there is a

conspicuous silence about the loss of libido expected

in both males and females on significant dietary

restriction.

Cold Intolerance

Organisms on CR become frigid in a literal sense as

well.

...1

Acronyms abound in the field of caloric restriction for

longevity. Like other movements with a public relations

problem, it seems to be searching for a label that projects a

more positive image. A sampler of the terms tried out

includes: caloric restriction (CR), dietary restriction (DR),

food restriction (FR), energy reduction (ER), caloric restriction

with adequate nutrition (CRAN), caloric restriction with

optimal nutrition (CRON), hypocaloric diet, high-quality

low-calorie diet, and undernutrition without malnutrition.

We use `CR' to denote generic calorie restriction (which can

apply to involuntary food deprivation, dieting, anorexic

eating patterns, or the regimen advised by researchers in this

area); we use `CRL' to refer more narrowly to the field and the

practice of caloric restriction for longevity.

...2

CR cannot be absolved from making some contribution to

the AN suicide statistics, in view of the association between

food deprivation and depression in normal individuals

(Keys, Brozek, Henschel, Mickelsen, & , 1950); in

addition, many AN patients link their suicidal ideation to

despair over the constricted life required by CR and self-loathing

for their inability to sustain it. It is probable,

however, that pre-existing psychopathology (quite likely

exacerbated by CR) explains most of the variance in deaths

by suicide. It is more awkward to contend that the negative

effects of bulimia should not count as direct costs of CR. Binge

eating is a lawful response to caloric insufficiency, and

purging a predictable reaction to its occurrence in people

committed to caloric control.

...3

If our suggestion that AN patients might be encouraged to

replace haphazard CR with proper CRL seems far-fetched,

the following post to the CR Society listserve is instructive:

`[CR practitioners should] reach out to specific groups who

might derive serious benefit from [CR] member-ship

....[including individuals with] anorexia or bulemia

[sic]. [We] can take these people in, not telling them that

they are ill, but rather informing them that thinness is not

only OK, but desirable ...They can be taught that both goals

[i.e. thinness and health] can be met together, and that they

will stay young and beautiful many extra years by [ensuring

adequate nutrition on a CRL regimen]. Instead of going to

therapy to deal with their mental aberration, they will attend

[CR support groups] to encourage their desire in a healthy

direction' (`Adzoe', 2002). Our own recommendation for the

fine-tuning of anorexic restriction is rhetorical; this corre-spondent

seems disturbingly sincere.

... 4

Consistent with the positive spin placed on every aspect of

life on CR, Walford repeatedly maintains that the Bio-spherians

`were not overly hungry' and `did not feel undue

hunger' while on their restricted regimen (Walford &

Walford, 1994, pp. 20, 24, 29). All the accounts we have

located from Walford's fellow team members contradict his

characterization of their experience. For example, Silverstone

(1993) indicated that `hunger was an almost constant

companion', (in kson, 1993) that `hunger was a

nearly constant, nagging presence', Alling and (1993)

that `hunger [was] ...always there to struggle against' and

Leigh (Associated Press, 1996) that `[it] made us all a little

cranky, always being hungry'. The classic semi-starvation

phenomena that emerged in Biosphere 2—including food

fantasizing, maximizing, hoarding, stealing, massing, sub-stitution

habits and mistrust of others over the distribution of

rations—are also inconsistent with the claim that participants

`were not overly hungry'.

... Anorexia Nervosa

The second example comes from our own specialty

area: the observation of patients with chronic, rela-tively

stable AN. If rodents and primates allocated

to a CR condition are the most fortunate of labora-tory

animals, these individuals hold the winning

ticket in the human species. Through their own

initiative—albeit for different reasons—they have

found their way to a dietary regimen that should

be associated with unprecedented health, vigour

and longevity.

In some senses, individuals with longstanding AN

make even better exemplars of human CRL than the

tiny sample of enclosed Biospherians. Their exis-tence

affirms that at least a few people can practise

radical restriction at liberty; their persistence means

that wecan trace its effects over much longer periods

than the token 2-year stint in Biosphere 2. Of course,

only a fraction of AN patients will meet criteria for

correct CR over time, and their compliance cannot

be verified with precision. Experts stress, however,

that the critical element in the CRL paradigm is

simply prolonged caloric deficit in the absence of

malnutrition. Some AN patients clearly fulfill those

specifications. So what can this subgroup of indivi-duals

tell us about serious, sustained CR outside the

context of the laboratory?

One ready conclusion is that CR does indeed

`work' for human beings, at least in the same limited

sense affirmed by the Biosphere data. CRL advo-cates

were excited (if not surprised) when food

restriction was shown to lower the blood pressure,

body temperature, glucose levels and white cell

counts of the eight Biospherians. Precisely the same

results can be read off the medical charts of thou-sands

of AN patients. (Moreover, such benefits are

discernible not only in the model cases who adopt

nutritionally sound CR, but the considerably larger

percentage of patients who practise unsanctioned

forms of restriction—although the animal research

predicts that only the former will enjoy the full array

of long-term benefits.) Two recent datasets also offer

tantalizing hints about the potential protective

power of prolonged CR. In one records-based study

of patients with possible, probable or definite AN

seen up to 63 years earlier, the total sample appeared

at heightened risk of death from psychiatric causes,

including suicide and alcoholism; however, all-cause

mortality was not elevated and there was a

decreased risk of death from cardiovascular disease

(Korndorfer et al., 2003; see discussions in Palmer,

2003, and Sullivan, 2003). Because of diagnostic

uncertainties and lack of information about diet

and duration, these findings are no more than sug-gestive.

But through the noise of methodological

limitations, the signal that CRL researchers would

most like to discern emits a faint hum. Whatever

damage ANmay reflect and/or inflict in other areas

of patients' lives, it could be working wonders in

their circulatory systems—just as imposed CR

improves the cardiovascular health of underfed

rodents and monkeys. Another retrospective study

of 7303 women previously hospitalized for AN

found a 53% lower incidence of breast cancer over

the follow-up interval (Michels & Ekbom, 2004)—

ironically, almost precisely matching the risk reduc-tion

for mammary tumours in energy-restricted

mice (Dirx, Zeegers, Dagnelie, van den Bogaard, &

van den Brandt, 2003).

On the other hand, data from the ED field suggest

that CR virtually never `works', in the sense that it is

rarely sustained over time and generally done quite

badly—even by individuals who are fiercely

committed to keeping it running and doing it right.

Dieters regain, `restrained' eaters limit their intake in

theory more than practice, and a majority of restrict-ing

anorexics slide inexorably towards bulimia.

Quite commonly, AN patients find themselves

unable to continue hard-core restraint without ever

having made an affirmative decision to let it go.

After years—sometimes even decades—of grimly

`successful' CR, they can no longer summon the

strength required for the constant battle with their

own biology.

We can also learn more about the significance of

the silent terms in the CRL syllogism by analysing

how some AN patients manage to restrict as

valiantly and persistently as they do. At the start of

their disorder, the external circumstances of anor-exics-

in-the-making show little resemblance to those

of lab rats or Biospherians. By the time AN is well

established, however, most have recreated a

strikingly similar environment. In effect, anorexic

individuals construct their own virtual cages and

move in for the duration of their illness. Each finds

her way, individually but lawfully, to the same set

of conditions that researchers create for animals on

CR: isolation from others; protected, predictable

and constricted surroundings; minimal demands

or expectations; fixed and monotonous rations; elim-ination

of activities and goals incompatible with the

maintenance of CR. It seems probable that those are

the only circumstances under which severe restric-tion

can be practised or endured. For psychological

reasons, individuals with AN may be willing to pay

the astronomical costs of chronic deprivation that

less troubled people reject as unacceptable. Advo-cates

of CRL are urging the general public to recon-sider,

in view of the objective benefits to be gained

from an anorexic lifestyle. From our perspective, it

is fortunate that their efforts will seldom succeed

(Vitousek & Gray, 2002).

Recently, experts have begun to acknowledge that

CRL may not gain widespread acceptance (e.g.

Mattson et al., 2003; Pinel et al., 2000; Roth et al.,

2001)—but they have yet to come to terms with

why that is so. Many seem to view the human reluc-tance

to semi-starve as a blend of ignorance, short-sightedness,

weakness and hedonism. Whatever

the merits of these models in explaining the steep

rise in obesity rates, they do not provide an adequate

account for the rejection of radical CR and subnor-mal

weight. To understand why Biospherians and

lab animals refeed the moment they are reprieved

from restriction—or why anorexics must retreat

from the world in order to pursue it —we need to

look to the CR syndrome itself. In addition to the

conservative biological changes that foster health

and longevity, the network of defensive reactions

to CR includes profound, predictable shifts in beha-viour,

cognition and affect. These neglected ele-ments

of the syndrome clarify why it can be

examined only in captive animals, enclosed Bio-spherians

and self-imprisoned individuals with

AN—and are the subject of the second paper in this

series (Vitousek, Manke, Gray, & Vitousek, European

Eating Disorders Review, in press).

...REFERENCES

`Adzoe'. (2002). Proactive and bullish CR. Retrieved July 7,

2003 from http://group./group/crsociety/

message 21136.

Research Article

Caloric restriction for longevity: II - The systematic

neglect of behavioural and psychological outcomes

in animal research

M. Vitousek, Frederic P. Manke, A. Gray, Maren N.

Vitousek

Published Online: 21 Oct 2004

DOI: 10.1002/erv.604, Full Text: PDF (Size: 212K)

Eur. Eat. Disorders Rev. 12, 338–360 (2004)

Research on caloric restriction for longevity (CRL) has generated

hundreds of articles on the physiology of food deprivation, yet

almost no data on consequences in other domains. The first paper in

this series outlined the generally positive physical effects of CRL;

the second analyses the meagre and sometimes disturbing record of

research on behaviour, cognition and affect. The available evidence

suggests that nutrient-dense CRL in animals—just like nutrient-poor

semi-starvation in people—is associated with a number of

adverse effects. Changes include abnormal food-related behaviour,

heightened aggression and diminished sexual activity. Studies of

learning and memory in underfed rodents yield inconsistent

findings; no information is available on cognitive effects in

primates. To date, the CRL field has ignored other variables that

are crucial to the human case and known to be disrupted by chronic

hunger, including sociability, curiosity and emotionality. Promo-tion

of CRL for people is irresponsible in the absence of more

reassuring data on the full range of expected outcomes. Eating

disorder specialists should be contributing to scientific and public

discussions of this increasingly prominent paradigm.

1

Because of the instrumental quality of someof the behavioural

responses to CR, it is difficult to avoid metaphors suggesting

that they were ordained by a granddesign. We occasionally use

such language when referring to the adaptive value of the CR

syndrome, implying that Nature `wants' the semi-starving

organism to be food-obsessed, irritable and asocial; however,

we do recognize the fallacy of imputed intent. Nature is not

invested in how individuals (or, for that matter, whole species)

feel, function or fare. Animals that react to famine in these

selected ways are simply likely to out-compete animals that do

not, surviving to bear and rear similarly disposed progeny.

...`There is a downside to caloric restriction, how-ever,

which is obvious even to a casual observer

who visits during mealtime. The monkeys go

crazy when the food shows up, grasping at their

meager rations'. (Weiss, 1997, p. 24)

...`All monkeys walked more before feeding than

afterwards, but restricted monkeys paced twice

as much as controls prior to eating and six times

more after food was offered. Before feeding,

restricted monkeys also exhibited more threaten-ing

displays, and also cooing, than controls. The

restricted monkeys ate and drank more inten-sively

than controls after food was given to them'.

(Ramsey et al., 2000, pp. 1142–1143)

...2

After this article was written, CRL researcher, popularizer

and practitioner Roy Walford died of amyotrophic lateral

sclerosis (ALS) at the age of 79. There is no basis for

speculating that his two decades on CR contributed to the

development of his disease—or that earlier or more stringent

CR could have prevented it. Although some obituaries noted

the discrepancy between his quite ordinary age at death and

his promotion of `the 120-year diet' (Walford, 1986, 2000),

Walford always emphasized (correctly) that his own long-evity

was merely a single data point in the study of human

CRL. He strayed from the evidence, however, when he

persisted on CR after the onset of his illness and credited the

diet for slowing its progression. An animal model of ALS

suggests that CR not only fails to protect against the disease

but accelerates its clinical course once it is underway

(Pedersen & Mattson, 1999).

...Heaps of data show that animals on CR retain

their youthful vigour, avoid many diseases and

enjoy remarkably long lives—and if you make

the commitment to undereat for decades, YOU

CAN TOO!

Reviewers do not similarly connect the dots with

reference to sexuality. No summary article on CRL

includes a parallel statement that extrapolates the

bad news from animals to people:

Heaps of data show that animals on CR have

decreased levels of sex hormones, little interest

in mating, and impaired fertility—and if you

make the commitment to undereat for decades,

YOU CAN TOO!

...`Although I had to steel myself when I first posted

my libido problems, it was amazing how many

other CR folks were suffering in silence. This is a

really serious issue, which Walford has swept

under the rug in his books'. (Sherman, 2000)

...`You may have to give up angel food cake [on a CR

regimen], but to those for whom sight, sense, and

sexuality are less important than angel food cake, I

have nothing to offer ...If you must have a certain

measure of sin, I suggest you give up gluttony and

accentuate one of the [other seven sins]: lust, for

example. [Critics of CR] and all you other sinners,

give up gluttony and double your lust!' (Walford,

1986, p. 30)

...3

While cognitive function is also fairly well preserved in AN,

the picture is not benign in severely ill patients. Neurocog-nitive

impairments and structural brain changes are often

detected (e.g. Kingston, Szmukler, es, Tress, &

Desmond, 1996; Lambe, Katzman, Mikulis, Kennedy, &

Zipursky, 1997; Mathias & Kent, 1998; Moser et al., 2003;

Swayze et al., 2003). Many (but not all) of these abnormalities

tend to reverse with weight restoration. It should not be

assumed that the same changes would occur on the

recommended CRL regimen; however, too little is known

about the mechanisms that produce them to rule out the

possibility of untoward effects, particularly in human

practitioners who reduce too fast, too far, or through resort

to disapproved techniques. The first published MRI study of

restricted monkeys determined that subjects on moderate,

nutritionally correct CR had lower volumes of the putamen

compared to controls, although the opposite pattern had been

predicted (Matochik et al., 2004); the significance of this

finding remains unclear in the early stages of primate

research.

...` Roth ...who is testing the monkeys'

behavior, says progress is frustrating. ``It's taking

a long time to train the monkeys to do the tasks,''

he says. ``We hope to get faster, but it's agoniz-ingly

slow,'' and he has no results to report.'

(Devitt, 1998, p. 1)

...`Clinically, anorexics do surprisingly well despite

their growing emaciation ...Far from being

lethargic, they are typically hyperenergized. Ser-ious

problems do not generally occur until 30

to 40 percent of [body weight] has been lost'.

(Weindruch & Walford, 1988, p. 303)

...4

In the end, the funding agency blinked when it came to

supporting CRL research with young, normal-weight parti-cipants,

as advised by the Hass et al. (1996) panel, opting

instead to fund studies of middle-aged and older volunteers

who were overweight but not obese. We agree that this was a

more ethically sound decision; however, the results may yield

limited information about the potential of human CRL

(Vitousek, Gray, & Talesfore, European Eating Disorders

Review, in press). Such research will also underestimate the

costs of CR for normal-weight individuals. ED experts

disagree about whether dieting is advisable for people who

are overweight (see discussions in Brownell & Rodin, 1994;

, 2002; Garner & Wooley, 1991; McFarlane, Polivy, &

McCabe, 1999; Wadden, Brownell, & , 2002; ,

2002). All concur, however, that CR by the underweight and

normal-weight elicits distinctive and much more negative

effects.

...5

As noted in the companion article (Vitousek, Gray, &

Grubbs, 2004), recent evidence indicates that at least one

strain of mouse does enough catch-up eating on every-other-day

feeding schedules to maintain near-normal caloric intake

and weight—yet profits from the life extension bonus of CR

all the same (Anson et al., 2003). Apparently, restricting-subtype

AN is not the only eating disorder that may provide

health benefits. The general pattern associated with non-purging

bulimia nervosa can also be endorsed, as long as

fasting and binge eating are appropriately spaced and

adequate nutrition is assured. A different set of problems

arises, however, when the same organisms who are experien-cing

the CR regimen are also administering the CR regimen.

Individuals who intend to fast all day often fail to make it past

mid-afternoon before the bingeing begins. Once again,

proponents of CRL would do well to consult the ED field

about the foreseeable fate of intermittent feeding schedules in

free-ranging humans.

...We anticipate that once CRL researchers do so,

they will be unable to make the case at all. It is

already clear—in part from research conducted

within the framework of CRL—that the food focus

and asexuality of semi-starvation are not mitigated

with micronutrients. There are insufficient data to

gauge whether consequences such as depression

will be reduced; it is a good guess that effects such

as decreased sociability and a narrowed scope of

interests will not. Indeed, it would be astonishing

if vitamin-enriched CRelicited the desired physiolo-gical

elements of the CRL syndrome while neatly

excising its inconvenient psychological compo-nents.

The vigorous behavioural, cognitive and

affective defences against undereating are not side-effects

but central effects of Nature's reaction to the

crisis of caloric deficit, as firmly embedded in the

`well-coordinated network' as changes on the cellu-lar

level. The physiology of CRL may be the pre-ferred

focus of specialists in this area, but the

phenomenon they have chosen to study does not

give them the freedom to pick and choose. The

CRL effect comes as a package deal for any organism

in which it is elicited; accordingly, it comes as a pack-age

deal for any investigator who hopes to describe,

understand or exploit it.

...Pomerleau, D. (2000). [CR] Just do it! [Msg 6676]. Message

posted to CR Society electronic mailing list, retrieved

April, 2001, from www. infinitefaculty.org/sci/cr/

crs/2001_01.txt

...Sherman, M. (2000). E-mail `Apology and testosterone

discussion', to crsociety list, June 1, 2000.

Invited Article

The case for semi-starvation (p 275-278)

M. Vitousek

Published Online: 26 Aug 2004

DOI: 10.1002/erv.593, Full Text: PDF (Size: 58K)

University of Hawaii, USA

The papers in this series assume familiarity with the clinical

manifestations of AN and semi-starvation; for additional

background on these topics, see Fairburn and Brownell (2002),

Garner (1997), Keys, Brozek, Henschel, Mickelsen and

(1950) and Polivy (1996).

The eating disorder field has been slow to respond to the pheno-

menon

of caloric restriction for longevity (CRL), currently a central

focus of research in biogerontology. On the basis of compelling

evidence that animals remain healthier and live longer on diets of

`anorexic' severity, some experts are recommending chronic self-

deprivation

to the general public. This brief article introduces a

series of papers on CRL, outlining the challenges and opportu-nities

the movement presents to our speciality area. Keywords: caloric

restriction; dietary restriction; longevity; ageing; eating disorders

To eating disorder (ED) specialists, severe caloric

restriction (CR) is a symptomatic behaviour. When

sustained for years, it imposes grave consequences

on the few troubled people who persist. Individuals

with anorexia nervosa (AN) often insist that they are

`healthy', but experts knowthat they are mistaken—

indeed, only through increased eating and weight

can they regain their health and begin to improve

their lives.

To a growing number of physiologists and geron-tologists,

severe CR is a miraculous paradigm and a

desirable goal. If practised for decades, it promises

extraordinary benefits to anyone with the wisdom

and self-discipline to persevere. The general public

may doubt that one can be `healthy' while eating

too little to support normal physiology and repro-duction.

Confidently, experts assure them that they

are mistaken—indeed, only through chronic under-eating

can they hope to retain their health and vigour

to the end of an unprecedented lifespan.

Which of these perspectives has the right take on

the merits of radical restraint? The short answer is

`both of the above'. For more than half a century,

separate lines of research have built strong empirical

support for each position. Readers of this specialty

journal will be familiar with the case against extreme

CR.1

As clinicians, we plead it daily to our anorexic

patients; as researchers, we add more evidence to

the file with every investigation. Yet as a field, we

have remained surprisingly ignorant of the oppos-ing

brief on behalf of semi-starvation. According to

scientists who study caloric restriction for longevity

(CRL), individuals with AN are basically on the

right track for the wrong reason. When drastic calo-ric

cutbacks are imposed on laboratory animals, spe-cies

ranging from flies and fish to mice and monkeys

all thrive (at least physically) on nutrient-dense

deprivation (Masoro, 1988; et al., 2001; Roth,

Ingram, & Lane, 2001; Weindruch & Walford, 1988).

The most striking pay-offs are delayed senescence

and increased lifespan—in some instances, nearly

doubling the maximal age at death relative to nor-mally

fed controls. The CRL effect holds for animals

that start out thin, fat or average weight, and is most

pronounced at the lowest level of intake compatible

with survival. The regimens used in such research,

then, are not just slimming diets for inactive, overfed

mice languishing in the laboratory; subjects on CR

reach the rodent equivalent of the anorexic zone.

Growth is retarded, body temperature is depressed,

fertility is impaired—yet on virtually every index

considered by the CRLfield, the semi-starved organ-ism

is better off in consequence.

Onthe strength of these findings, CRL experts pre-dict

that tremendous benefits would accrue if people

could be persuaded to start undereating between the

ages of 18 and 30 and remain hungry throughout

their adult lives. Pilot research using human recruits

was recently initiated in the United States, with

funding from the National Institutes of Health. Some

scientists are so confident of the results that they

have already assigned themselves to a CR condition,

reducing their own caloric intake by as much as 40%.

Asmall but growing cohort of lay pioneers is follow-ing

their example. Unsurprisingly, most of those

who attempt the regimen fail (or fall back on such

modest dietary restraint that their behaviour is bet-ter

described as `sensible eating' than CRL). Afew of

the most fervid, however, are maintaining levels of

intake and weight consistent with laboratory ani-mals

on CR—or patients with AN. Little is known

about these freelance restricters, but the bits of infor-mation

available fulfill the predictions of both the

CRL and ED fields. Short-term physiological

changes conform to those seen in underfed rodents

that survive to great age in excellent health (Fontana,

Meyer, Klein, & Holloszy, 2004). On the other

hand, the psychological and behavioural effects

resemble symptoms of AN, including food preoc-cupation,

binge eating, social withdrawal, loss of

libido, extreme obsessionality, cultivated food pho-bias,

and the emergence of feelings of `specialness'

and superiority for the triumph of will over appetite

(Manke & Vitousek, 2002).

Clearly, the two groups of researchers studying

different aspects of CR need to become better

acquainted. For a variety of reasons, it is incumbent

on ED experts to take the lead in breaking through

the artificial boundaries that have kept these scienti-fic

communities isolated and inbred. The papers in

this series were written to facilitate that objective.

The first and second summarize the vast animal lit-erature

on CRL, reviewing both the beneficial conse-quences

that are featured by investigators and the

deleterious effects that are obscured. The initial arti-cle

(Vitousek, Gray, & Grubbs, this issue) provides a

primer on the basics of CRL for an ED audience, out-lining

the protocols used and the physiological

changes they produce. The paper also highlights

the importance of considering the context within

which CR occurs, comparing underfeeding in the

laboratory to human restriction in the Biosphere 2

project and instances of AN. The second article

examines what the CRL field does—and mostly

doesn't—know about the behavioural, social, cogni-tive

and affective consequences of deprivation

(Vitousek, Manke, Gray, & Vitousek, European Eat-ing

Disorders Review, in press). Researchers have

shown little interest in these domains; however,

the available evidence indicates that nutrient-dense

CR in animals—just like nutrient-poor semi-starva-tion

in people—is associated with numerous

adverse effects. A third paper (Vitousek, Gray, &

Talesfore, in press) addresses human applications

of the paradigm, with specific proposals for

increased collaboration—as well as confronta-tion—

between the ED and CRL areas.

WHAT'S IN IT FOR THE ED FIELD?

At first pass, it is easier to see what ED experts can

offer CRL researchers than to recognize what they

can do for us—at least in any positive sense. We

have considerable knowledge about failed and `suc-cessful'

restriction in the species they are beginning

to study, and some insight into what it takes to semi-starve

outside the laboratory. A subset of our

patients could also provide preliminary data about

the physiology and health outcomes of chronic

human CR, decades before more satisfactory

answers might be obtained through controlled

research (Vitousek, Gray, & Talesfore, in press).

Indeed, two recent studies have already reported

that a history of ANdecreases subsequent risk of car-diovascular

disease (Korndorfer et al., 2003) and

breast cancer (Michels & Ekbom, 2004), supporting

the CRL view that semi-starvation can be construed

as preventive medicine.

By contrast, the most obvious effect of the CRL

movement on our own work will be to make it more

difficult. The scientific endorsement of semi-starvation

will be confusing to many of our patients

and exploited by some; certainly, it will muddle our

message about the futility of dieting by the normal

weight. We do not need to sound the alarm, how-ever,

about a looming epidemic of CRL in the gen-eral

population. Americans have boosted their

intake an estimated 300–500 kcal/day over the last

30 years (Putnam, 1999; United States Department

of Agriculture, 2002), despite a barrage of publicity

about the relationship between overeating and pre-mature

death. Publicity about the linkage between

undereating and postponed death is unlikely to

send millions charging in the opposite direction. If

visions of immortality do inspire some people to

trim back caloric excess, it may be good for their

health—but it will not be CRL. Presumably, we

cannot expect to shatter the lifespan barrier simply

by eating 300 fewer calories per day if we are cur-rently

eating 300 more than the generation that pre-ceded

us.

For the few who attempt the real thing, however,

ED specialists would forecast less favourable out-comes.

Far more will be left with a legacy of binge

eating, increased adiposity and unwarranted guilt

over the abandonment of extreme CR than will see

their 130th birthdays. The rare individual who gets

into the swing of semi-starvation will do so by pick-ing

up the monotonous rhythms and rituals of

restricting AN.All the evidence suggests that radical

CR is incompatible with a life—of whatever dura-tion—

that is genuinely lived `at liberty' (Vitousek,

Gray, & Grubbs, this issue).

Yet within these disheartening prospects, the CRL

movement affords some extraordinary opportu-nities

to our specialty area (Vitousek, Gray, &

Talesfore, in press). While few ED experts would

endorse the adoption of CRL by people—within or

outside the context of research—we would be foolish

to ignore an emerging phenomenon that we oppose

but cannot control. Because semi-starvation affects

so many aspects of functioning, efforts to decode

the physiology and psychology of AN have always

been hampered by the lack of an appropriate com-parison

group. When we detect peculiar neuropep-tide

levels or distinctive cognitive styles in

individuals with AN, we cannot sort out the signifi-cance

of those findings by comparing our patients to

normal, psychiatric, or even dieting controls. The

only satisfactory match for an otherwise healthy

anorexic person with a BMI of 16 is an otherwise

healthy non-anorexic person with a BMI of 16. For

all the reasons reviewed in this series of articles, the

latter virtually never occurs in nature—but does,

very rarely, occur through freelance CRL. For the

first time since the Minnesota Study (Keys et al.,

1950), we have the opportunity to observe sustained

semi-starvation in presumably normal individuals

leading more or less ordinary lives in peaceful and

prosperous societies.

In addition to the research opportunities afforded

by CRL, the phenomenon may also help us see a

familiar disorder from a fresh perspective. In cases

of extreme CRL, we are witnessing the emergence

of eerily `anorexic' beliefs and behaviours in indivi-duals

(such as middle-aged males) at close-to-zero

risk for a conventional ED (Manke & Vitousek,

2002; Vitousek, Gray, & Talesfore, in press). More-over,

we can often trace the origin of their stereo-typed

symptoms to a specific idea to which they

were exposed at an identifiable point in time and

resolved to pursue consciously and purposefully.

In their view, the costs of chronic CR are justified

by its anticipated rewards—and many sane, serious

scientists agree. In other words, the identification of

a different reason for semi-starvation shifts the popu-lation

`at risk' and changes assessments of its ration-ality.

Patterns that appear mysterious and

pathological in the context of ANcan be seen as sen-sible,

even admirable, in the service of goals that

observers understand and endorse.

Our own view is that both the pursuit of thinness

and the pursuit of longevity are insufficient bases for

radical restraint; however, if the example of CRL can

illuminate the power of personally compelling

motives for disordered eating, the ED field will ben-efit

from giving it more thoughtful attention.

REFERENCES

Fairburn, C. G., & Brownell, K. D. (Eds.), (2002). Eating

disorders and obesity: A comprehensive handbook. New

York: Guilford Press.

Fontana, L., Meyer, T. E., Klein, S., & Holloszy, J. O.

(2004). Long-term calorie restriction is highly effective

in reducing the risk for atherosclerosis in humans.

Proceedings of the National Academy of Sciences, 10, 6659–

6663.

Garner, D. M. (1997). Psychoeducational principles in

treatment. In D. M. Garner, & P. E. Garfinkel (Eds.),

Handbook of treatment for eating disorders (2nd ed.) (pp.

145–177). New York: Guilford Press.

Keys, A., Brozek, J., Henschel, A., Mickelsen, O., & ,

H. L. (1950). The biology of human starvation (2 vols).

Minneapolis, MN: University of Minnesota Press.

Korndorfer, S. R., Lucas, A. R., Suman, V. J., Crowson,

C. S., Krahn, L. E., & Melton, L. J. III (2003). Long-term

survival of patients with anorexia nervosa: A popula-tion-

based study in Rochester, Minn. Mayo Clinic

Proceedings, 78, 278–284.

Manke, F. P., & Vitousek, K. M. (2002). Comment:

Hunger, semi-starvation, and ill-health. American

Psychologist, 57, 371–372.

Masoro, E. J. (1988). Food restriction in rodents: An

evaluation of its role in the study of aging. Journal of

Gerontology: Biological Sciences, 43, B59–B64.

Michels, K. B., & Ekbom, A. (2004). Caloric restriction and

incidence of breast cancer. JAMA, 291, 1226–1230.

Polivy, J. (1996). Psychological consequences of food

restriction. Journal of the American Dietetic Association,

96, 589–592.

Putnam, J. (1999). U.S. food supply providing more food

and calories. Food Review, 22, 2–12.

, S. B., Pi-Sunyer, X., Kuller, L., Lane, M. A.,

Ellison, P., Prior, J. C., et al. (2001). Physiologic effects

of lowering caloric intake in nonhuman primates and

nonobese humans. Journals of Gerontology (Series A),

56A, 66–75.

Cheers, Alan Pater

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That's a good qualification.. " if one suspects ... "

Dr. Walford suggests shooting for 10% below what one's bodyweight was

at a young age like highschool.. (I assume this group does not

consider this extreme?)

And this might be a good [rough] measure..

But..

What if one was overweight during this period in life? The one has no

ready reference to draw from.

I hate to seem to be harping on it..

But low BF level is really what Dr. Walford had in mind ..

So, isn't shooting for <5% or so BF what he had in mind? Is this

extreme? What purpose does more BF serve??

If you get down to 5% BF with good nutrition you are pretty much on

target, right??

> > > >

> > > > " However, I have a BMI above 19, and my doctor thinks I'm " in

> > > really

> > > > good shape. " > so why worry about weight, just look at you

> > > calories,

> > > > they are the factor, you can be as thin as a rake on 3000 cals

> if

> > > > you are very active (but CR is all about Calories and Optimum

> > > > Nutrition, weight will sort itself out and if it gets to low

> your

> > > > doctor will say).

> > > >

> > > > The " I-know-it-when-I-see-it " argument makes me nervous. It

> seems a

> > > > bit too subjective.

> > > >

> > > > It may be subjective, but if you come into calorie restriction

> > > > without anorexic tendencies then you will know what slim means,

> > > what

> > > > thin means and what anorexic means. Looking at these five

> pictures

> > > > of Dean P as he calorie restricted over a few years. There is a

> > > > point (which will vary with individuals) at which Deans body is

> > > > enough for them and they wish to go no further. To me dean

> seemed

> > > to

> > > > start at a good weight/look, then got thin then ended up

> looking

> > > > anorexic (but I am not saying he is anorexic, but I certainly

> would

> > > > not want to look like that, it looks too fragile). He eats

> around

> > > > 1800 cals a day (and is total vegan having recently given up

> whey)

> > > >

> > > > http://deanpomerleau.tripod.com/pictures/index.htm

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This is hard to read do you have links to original sources?

> >

> > >>>

> > From: " uptownguy34 " <uptownguy34@y...>

> > Date: Mon Oct 25, 2004 5:53 pm

> > Subject: What is extreme CR?

> > >>>

> >

> > There is a series of three papers by Vitousek, et. al, from

> the

> > department of psychology, University of Hawaii, that portray caloric

> > restriction as an anorexic lifestyle called the " CR syndrome " . The

> > authors say that Walford put a positive spin on food deprivation and

> > understated the degree of hunger and deprivation in the Biosphere.

> > The authors even used some of the postings on the

> > calorierestriction.org web site as references to document the

> reduced

> > libido and other physical problems of CR practitioners. According

> to

> > the author, " To eating disorder (ED) specialists, severe caloric

> > restriction (CR) is a symptomatic behaviour. When sustained for

> years,

> > it imposes grave consequences on the few troubled people who

> persist. "

> >

> > What can we learn from this? 1) What you post can be used against

> you

> > in unexpected ways. 2) CR is viewed as something abnormal practiced

> by

> > people with some mental compulsion or disorder.

> >

> > Tony

> >

> > ===

> >

> > European Eating Disorders Review, 12, Issue 5 (September/October

> 2004)

> > Caloric restriction for longevity: I. Paradigm, protocols

> > and physiological findings in animal research (p 279-299)

> > M. Vitousek, A. Gray, Kathleen M. Grubbs

> >

> > Caloric restriction for longevity: II - The systematic neglect of

> > behavioural and psychological outcomes in animal research.

> > M. Vitousek, Frederic P. Manke, A. Gray, Maren N.

> > Vitousek, Eur. Eat. Disorders Rev. 12, 338–360 (2004)

> >

> > The case for semi-starvation (p 275-278)

> > M. Vitousek, Published Online: 26 Aug 2004

>

>

> Hi All,

>

> M. Vitousek does throw a challenge to CRers in the below.

>

> Note the references to the CR Society file archives for Dean P and

> Sherm.

>

> There is a huge amount of information that may be swamped by

> presenting the three below pdfs in full, but the three-page overview

> may somewhat suffice.

>

> The pdfs are available as is the in press one below.

>

> European Eating Disorders Review, 12, Issue 5 (September/October

> 2004)

> Caloric restriction for longevity: I. Paradigm, protocols

> and physiological findings in animal research (p 279-299)

> M. Vitousek, A. Gray, Kathleen M. Grubbs

> Published Online: 26 Aug 2004

> DOI: 10.1002/erv.594, Full Text: PDF (Size: 192K)

> ... Across the CRL literature, there is a

> conspicuous silence about the loss of libido expected

> in both males and females on significant dietary

> restriction.

> Cold Intolerance

> Organisms on CR become frigid in a literal sense as

> well.

> ...1

> Acronyms abound in the field of caloric restriction for

> longevity. Like other movements with a public relations

> problem, it seems to be searching for a label that projects a

> more positive image. A sampler of the terms tried out

> includes: caloric restriction (CR), dietary restriction (DR),

> food restriction (FR), energy reduction (ER), caloric restriction

> with adequate nutrition (CRAN), caloric restriction with

> optimal nutrition (CRON), hypocaloric diet, high-quality

> low-calorie diet, and undernutrition without malnutrition.

> We use `CR' to denote generic calorie restriction (which can

> apply to involuntary food deprivation, dieting, anorexic

> eating patterns, or the regimen advised by researchers in this

> area); we use `CRL' to refer more narrowly to the field and the

> practice of caloric restriction for longevity.

> ...2

> CR cannot be absolved from making some contribution to

> the AN suicide statistics, in view of the association between

> food deprivation and depression in normal individuals

> (Keys, Brozek, Henschel, Mickelsen, & , 1950); in

> addition, many AN patients link their suicidal ideation to

> despair over the constricted life required by CR and self-loathing

> for their inability to sustain it. It is probable,

> however, that pre-existing psychopathology (quite likely

> exacerbated by CR) explains most of the variance in deaths

> by suicide. It is more awkward to contend that the negative

> effects of bulimia should not count as direct costs of CR. Binge

> eating is a lawful response to caloric insufficiency, and

> purging a predictable reaction to its occurrence in people

> committed to caloric control.

> ...3

> If our suggestion that AN patients might be encouraged to

> replace haphazard CR with proper CRL seems far-fetched,

> the following post to the CR Society listserve is instructive:

> `[CR practitioners should] reach out to specific groups who

> might derive serious benefit from [CR] member-ship

> ...[including individuals with] anorexia or bulemia

> [sic]. [We] can take these people in, not telling them that

> they are ill, but rather informing them that thinness is not

> only OK, but desirable ...They can be taught that both goals

> [i.e. thinness and health] can be met together, and that they

> will stay young and beautiful many extra years by [ensuring

> adequate nutrition on a CRL regimen]. Instead of going to

> therapy to deal with their mental aberration, they will attend

> [CR support groups] to encourage their desire in a healthy

> direction' (`Adzoe', 2002). Our own recommendation for the

> fine-tuning of anorexic restriction is rhetorical; this corre-spondent

> seems disturbingly sincere.

> ... 4

> Consistent with the positive spin placed on every aspect of

> life on CR, Walford repeatedly maintains that the Bio-spherians

> `were not overly hungry' and `did not feel undue

> hunger' while on their restricted regimen (Walford &

> Walford, 1994, pp. 20, 24, 29). All the accounts we have

> located from Walford's fellow team members contradict his

> characterization of their experience. For example, Silverstone

> (1993) indicated that `hunger was an almost constant

> companion', (in kson, 1993) that `hunger was a

> nearly constant, nagging presence', Alling and (1993)

> that `hunger [was] ...always there to struggle against' and

> Leigh (Associated Press, 1996) that `[it] made us all a little

> cranky, always being hungry'. The classic semi-starvation

> phenomena that emerged in Biosphere 2—including food

> fantasizing, maximizing, hoarding, stealing, massing, sub-stitution

> habits and mistrust of others over the distribution of

> rations—are also inconsistent with the claim that participants

> `were not overly hungry'.

> ... Anorexia Nervosa

> The second example comes from our own specialty

> area: the observation of patients with chronic, rela-tively

> stable AN. If rodents and primates allocated

> to a CR condition are the most fortunate of labora-tory

> animals, these individuals hold the winning

> ticket in the human species. Through their own

> initiative—albeit for different reasons—they have

> found their way to a dietary regimen that should

> be associated with unprecedented health, vigour

> and longevity.

> In some senses, individuals with longstanding AN

> make even better exemplars of human CRL than the

> tiny sample of enclosed Biospherians. Their exis-tence

> affirms that at least a few people can practise

> radical restriction at liberty; their persistence means

> that wecan trace its effects over much longer periods

> than the token 2-year stint in Biosphere 2. Of course,

> only a fraction of AN patients will meet criteria for

> correct CR over time, and their compliance cannot

> be verified with precision. Experts stress, however,

> that the critical element in the CRL paradigm is

> simply prolonged caloric deficit in the absence of

> malnutrition. Some AN patients clearly fulfill those

> specifications. So what can this subgroup of indivi-duals

> tell us about serious, sustained CR outside the

> context of the laboratory?

> One ready conclusion is that CR does indeed

> `work' for human beings, at least in the same limited

> sense affirmed by the Biosphere data. CRL advo-cates

> were excited (if not surprised) when food

> restriction was shown to lower the blood pressure,

> body temperature, glucose levels and white cell

> counts of the eight Biospherians. Precisely the same

> results can be read off the medical charts of thou-sands

> of AN patients. (Moreover, such benefits are

> discernible not only in the model cases who adopt

> nutritionally sound CR, but the considerably larger

> percentage of patients who practise unsanctioned

> forms of restriction—although the animal research

> predicts that only the former will enjoy the full array

> of long-term benefits.) Two recent datasets also offer

> tantalizing hints about the potential protective

> power of prolonged CR. In one records-based study

> of patients with possible, probable or definite AN

> seen up to 63 years earlier, the total sample appeared

> at heightened risk of death from psychiatric causes,

> including suicide and alcoholism; however, all-cause

> mortality was not elevated and there was a

> decreased risk of death from cardiovascular disease

> (Korndorfer et al., 2003; see discussions in Palmer,

> 2003, and Sullivan, 2003). Because of diagnostic

> uncertainties and lack of information about diet

> and duration, these findings are no more than sug-gestive.

> But through the noise of methodological

> limitations, the signal that CRL researchers would

> most like to discern emits a faint hum. Whatever

> damage ANmay reflect and/or inflict in other areas

> of patients' lives, it could be working wonders in

> their circulatory systems—just as imposed CR

> improves the cardiovascular health of underfed

> rodents and monkeys. Another retrospective study

> of 7303 women previously hospitalized for AN

> found a 53% lower incidence of breast cancer over

> the follow-up interval (Michels & Ekbom, 2004)—

> ironically, almost precisely matching the risk reduc-tion

> for mammary tumours in energy-restricted

> mice (Dirx, Zeegers, Dagnelie, van den Bogaard, &

> van den Brandt, 2003).

> On the other hand, data from the ED field suggest

> that CR virtually never `works', in the sense that it is

> rarely sustained over time and generally done quite

> badly—even by individuals who are fiercely

> committed to keeping it running and doing it right.

> Dieters regain, `restrained' eaters limit their intake in

> theory more than practice, and a majority of restrict-ing

> anorexics slide inexorably towards bulimia.

> Quite commonly, AN patients find themselves

> unable to continue hard-core restraint without ever

> having made an affirmative decision to let it go.

> After years—sometimes even decades—of grimly

> `successful' CR, they can no longer summon the

> strength required for the constant battle with their

> own biology.

> We can also learn more about the significance of

> the silent terms in the CRL syllogism by analysing

> how some AN patients manage to restrict as

> valiantly and persistently as they do. At the start of

> their disorder, the external circumstances of anor-exics-

> in-the-making show little resemblance to those

> of lab rats or Biospherians. By the time AN is well

> established, however, most have recreated a

> strikingly similar environment. In effect, anorexic

> individuals construct their own virtual cages and

> move in for the duration of their illness. Each finds

> her way, individually but lawfully, to the same set

> of conditions that researchers create for animals on

> CR: isolation from others; protected, predictable

> and constricted surroundings; minimal demands

> or expectations; fixed and monotonous rations; elim-ination

> of activities and goals incompatible with the

> maintenance of CR. It seems probable that those are

> the only circumstances under which severe restric-tion

> can be practised or endured. For psychological

> reasons, individuals with AN may be willing to pay

> the astronomical costs of chronic deprivation that

> less troubled people reject as unacceptable. Advo-cates

> of CRL are urging the general public to recon-sider,

> in view of the objective benefits to be gained

> from an anorexic lifestyle. From our perspective, it

> is fortunate that their efforts will seldom succeed

> (Vitousek & Gray, 2002).

> Recently, experts have begun to acknowledge that

> CRL may not gain widespread acceptance (e.g.

> Mattson et al., 2003; Pinel et al., 2000; Roth et al.,

> 2001)—but they have yet to come to terms with

> why that is so. Many seem to view the human reluc-tance

> to semi-starve as a blend of ignorance, short-sightedness,

> weakness and hedonism. Whatever

> the merits of these models in explaining the steep

> rise in obesity rates, they do not provide an adequate

> account for the rejection of radical CR and subnor-mal

> weight. To understand why Biospherians and

> lab animals refeed the moment they are reprieved

> from restriction—or why anorexics must retreat

> from the world in order to pursue it —we need to

> look to the CR syndrome itself. In addition to the

> conservative biological changes that foster health

> and longevity, the network of defensive reactions

> to CR includes profound, predictable shifts in beha-viour,

> cognition and affect. These neglected ele-ments

> of the syndrome clarify why it can be

> examined only in captive animals, enclosed Bio-spherians

> and self-imprisoned individuals with

> AN—and are the subject of the second paper in this

> series (Vitousek, Manke, Gray, & Vitousek, European

> Eating Disorders Review, in press).

> ...REFERENCES

> `Adzoe'. (2002). Proactive and bullish CR. Retrieved July 7,

> 2003 from http://group./group/crsociety/

> message 21136.

>

> Research Article

> Caloric restriction for longevity: II - The systematic

> neglect of behavioural and psychological outcomes

> in animal research

> M. Vitousek, Frederic P. Manke, A. Gray, Maren N.

> Vitousek

> Published Online: 21 Oct 2004

> DOI: 10.1002/erv.604, Full Text: PDF (Size: 212K)

> Eur. Eat. Disorders Rev. 12, 338–360 (2004)

> Research on caloric restriction for longevity (CRL) has generated

> hundreds of articles on the physiology of food deprivation, yet

> almost no data on consequences in other domains. The first paper in

> this series outlined the generally positive physical effects of CRL;

> the second analyses the meagre and sometimes disturbing record of

> research on behaviour, cognition and affect. The available evidence

> suggests that nutrient-dense CRL in animals—just like nutrient-poor

> semi-starvation in people—is associated with a number of

> adverse effects. Changes include abnormal food-related behaviour,

> heightened aggression and diminished sexual activity. Studies of

> learning and memory in underfed rodents yield inconsistent

> findings; no information is available on cognitive effects in

> primates. To date, the CRL field has ignored other variables that

> are crucial to the human case and known to be disrupted by chronic

> hunger, including sociability, curiosity and emotionality. Promo-tion

> of CRL for people is irresponsible in the absence of more

> reassuring data on the full range of expected outcomes. Eating

> disorder specialists should be contributing to scientific and public

> discussions of this increasingly prominent paradigm.

> 1

> Because of the instrumental quality of someof the behavioural

> responses to CR, it is difficult to avoid metaphors suggesting

> that they were ordained by a granddesign. We occasionally use

> such language when referring to the adaptive value of the CR

> syndrome, implying that Nature `wants' the semi-starving

> organism to be food-obsessed, irritable and asocial; however,

> we do recognize the fallacy of imputed intent. Nature is not

> invested in how individuals (or, for that matter, whole species)

> feel, function or fare. Animals that react to famine in these

> selected ways are simply likely to out-compete animals that do

> not, surviving to bear and rear similarly disposed progeny.

> ...`There is a downside to caloric restriction, how-ever,

> which is obvious even to a casual observer

> who visits during mealtime. The monkeys go

> crazy when the food shows up, grasping at their

> meager rations'. (Weiss, 1997, p. 24)

> ...`All monkeys walked more before feeding than

> afterwards, but restricted monkeys paced twice

> as much as controls prior to eating and six times

> more after food was offered. Before feeding,

> restricted monkeys also exhibited more threaten-ing

> displays, and also cooing, than controls. The

> restricted monkeys ate and drank more inten-sively

> than controls after food was given to them'.

> (Ramsey et al., 2000, pp. 1142–1143)

> ...2

> After this article was written, CRL researcher, popularizer

> and practitioner Roy Walford died of amyotrophic lateral

> sclerosis (ALS) at the age of 79. There is no basis for

> speculating that his two decades on CR contributed to the

> development of his disease—or that earlier or more stringent

> CR could have prevented it. Although some obituaries noted

> the discrepancy between his quite ordinary age at death and

> his promotion of `the 120-year diet' (Walford, 1986, 2000),

> Walford always emphasized (correctly) that his own long-evity

> was merely a single data point in the study of human

> CRL. He strayed from the evidence, however, when he

> persisted on CR after the onset of his illness and credited the

> diet for slowing its progression. An animal model of ALS

> suggests that CR not only fails to protect against the disease

> but accelerates its clinical course once it is underway

> (Pedersen & Mattson, 1999).

> ...Heaps of data show that animals on CR retain

> their youthful vigour, avoid many diseases and

> enjoy remarkably long lives—and if you make

> the commitment to undereat for decades, YOU

> CAN TOO!

> Reviewers do not similarly connect the dots with

> reference to sexuality. No summary article on CRL

> includes a parallel statement that extrapolates the

> bad news from animals to people:

> Heaps of data show that animals on CR have

> decreased levels of sex hormones, little interest

> in mating, and impaired fertility—and if you

> make the commitment to undereat for decades,

> YOU CAN TOO!

> ...`Although I had to steel myself when I first posted

> my libido problems, it was amazing how many

> other CR folks were suffering in silence. This is a

> really serious issue, which Walford has swept

> under the rug in his books'. (Sherman, 2000)

> ...`You may have to give up angel food cake [on a CR

> regimen], but to those for whom sight, sense, and

> sexuality are less important than angel food cake, I

> have nothing to offer ...If you must have a certain

> measure of sin, I suggest you give up gluttony and

> accentuate one of the [other seven sins]: lust, for

> example. [Critics of CR] and all you other sinners,

> give up gluttony and double your lust!' (Walford,

> 1986, p. 30)

> ...3

> While cognitive function is also fairly well preserved in AN,

> the picture is not benign in severely ill patients. Neurocog-nitive

> impairments and structural brain changes are often

> detected (e.g. Kingston, Szmukler, es, Tress, &

> Desmond, 1996; Lambe, Katzman, Mikulis, Kennedy, &

> Zipursky, 1997; Mathias & Kent, 1998; Moser et al., 2003;

> Swayze et al., 2003). Many (but not all) of these abnormalities

> tend to reverse with weight restoration. It should not be

> assumed that the same changes would occur on the

> recommended CRL regimen; however, too little is known

> about the mechanisms that produce them to rule out the

> possibility of untoward effects, particularly in human

> practitioners who reduce too fast, too far, or through resort

> to disapproved techniques. The first published MRI study of

> restricted monkeys determined that subjects on moderate,

> nutritionally correct CR had lower volumes of the putamen

> compared to controls, although the opposite pattern had been

> predicted (Matochik et al., 2004); the significance of this

> finding remains unclear in the early stages of primate

> research.

> ...` Roth ...who is testing the monkeys'

> behavior, says progress is frustrating. ``It's taking

> a long time to train the monkeys to do the tasks,''

> he says. ``We hope to get faster, but it's agoniz-ingly

> slow,'' and he has no results to report.'

> (Devitt, 1998, p. 1)

> ...`Clinically, anorexics do surprisingly well despite

> their growing emaciation ...Far from being

> lethargic, they are typically hyperenergized. Ser-ious

> problems do not generally occur until 30

> to 40 percent of [body weight] has been lost'.

> (Weindruch & Walford, 1988, p. 303)

> ...4

> In the end, the funding agency blinked when it came to

> supporting CRL research with young, normal-weight parti-cipants,

> as advised by the Hass et al. (1996) panel, opting

> instead to fund studies of middle-aged and older volunteers

> who were overweight but not obese. We agree that this was a

> more ethically sound decision; however, the results may yield

> limited information about the potential of human CRL

> (Vitousek, Gray, & Talesfore, European Eating Disorders

> Review, in press). Such research will also underestimate the

> costs of CR for normal-weight individuals. ED experts

> disagree about whether dieting is advisable for people who

> are overweight (see discussions in Brownell & Rodin, 1994;

> , 2002; Garner & Wooley, 1991; McFarlane, Polivy, &

> McCabe, 1999; Wadden, Brownell, & , 2002; ,

> 2002). All concur, however, that CR by the underweight and

> normal-weight elicits distinctive and much more negative

> effects.

> ...5

> As noted in the companion article (Vitousek, Gray, &

> Grubbs, 2004), recent evidence indicates that at least one

> strain of mouse does enough catch-up eating on every-other-day

> feeding schedules to maintain near-normal caloric intake

> and weight—yet profits from the life extension bonus of CR

> all the same (Anson et al., 2003). Apparently, restricting-subtype

> AN is not the only eating disorder that may provide

> health benefits. The general pattern associated with non-purging

> bulimia nervosa can also be endorsed, as long as

> fasting and binge eating are appropriately spaced and

> adequate nutrition is assured. A different set of problems

> arises, however, when the same organisms who are experien-cing

> the CR regimen are also administering the CR regimen.

> Individuals who intend to fast all day often fail to make it past

> mid-afternoon before the bingeing begins. Once again,

> proponents of CRL would do well to consult the ED field

> about the foreseeable fate of intermittent feeding schedules in

> free-ranging humans.

> ...We anticipate that once CRL researchers do so,

> they will be unable to make the case at all. It is

> already clear—in part from research conducted

> within the framework of CRL—that the food focus

> and asexuality of semi-starvation are not mitigated

> with micronutrients. There are insufficient data to

> gauge whether consequences such as depression

> will be reduced; it is a good guess that effects such

> as decreased sociability and a narrowed scope of

> interests will not. Indeed, it would be astonishing

> if vitamin-enriched CRelicited the desired physiolo-gical

> elements of the CRL syndrome while neatly

> excising its inconvenient psychological compo-nents.

> The vigorous behavioural, cognitive and

> affective defences against undereating are not side-effects

> but central effects of Nature's reaction to the

> crisis of caloric deficit, as firmly embedded in the

> `well-coordinated network' as changes on the cellu-lar

> level. The physiology of CRL may be the pre-ferred

> focus of specialists in this area, but the

> phenomenon they have chosen to study does not

> give them the freedom to pick and choose. The

> CRL effect comes as a package deal for any organism

> in which it is elicited; accordingly, it comes as a pack-age

> deal for any investigator who hopes to describe,

> understand or exploit it.

> ...Pomerleau, D. (2000). [CR] Just do it! [Msg 6676]. Message

> posted to CR Society electronic mailing list, retrieved

> April, 2001, from www. infinitefaculty.org/sci/cr/

> crs/2001_01.txt

> ...Sherman, M. (2000). E-mail `Apology and testosterone

> discussion', to crsociety list, June 1, 2000.

>

> Invited Article

> The case for semi-starvation (p 275-278)

> M. Vitousek

> Published Online: 26 Aug 2004

> DOI: 10.1002/erv.593, Full Text: PDF (Size: 58K)

> University of Hawaii, USA

> The papers in this series assume familiarity with the clinical

> manifestations of AN and semi-starvation; for additional

> background on these topics, see Fairburn and Brownell (2002),

> Garner (1997), Keys, Brozek, Henschel, Mickelsen and

> (1950) and Polivy (1996).

> The eating disorder field has been slow to respond to the pheno-

> menon

> of caloric restriction for longevity (CRL), currently a central

> focus of research in biogerontology. On the basis of compelling

> evidence that animals remain healthier and live longer on diets of

> `anorexic' severity, some experts are recommending chronic self-

> deprivation

> to the general public. This brief article introduces a

> series of papers on CRL, outlining the challenges and opportu-nities

> the movement presents to our speciality area. Keywords: caloric

> restriction; dietary restriction; longevity; ageing; eating disorders

> To eating disorder (ED) specialists, severe caloric

> restriction (CR) is a symptomatic behaviour. When

> sustained for years, it imposes grave consequences

> on the few troubled people who persist. Individuals

> with anorexia nervosa (AN) often insist that they are

> `healthy', but experts knowthat they are mistaken—

> indeed, only through increased eating and weight

> can they regain their health and begin to improve

> their lives.

> To a growing number of physiologists and geron-tologists,

> severe CR is a miraculous paradigm and a

> desirable goal. If practised for decades, it promises

> extraordinary benefits to anyone with the wisdom

> and self-discipline to persevere. The general public

> may doubt that one can be `healthy' while eating

> too little to support normal physiology and repro-duction.

> Confidently, experts assure them that they

> are mistaken—indeed, only through chronic under-eating

> can they hope to retain their health and vigour

> to the end of an unprecedented lifespan.

> Which of these perspectives has the right take on

> the merits of radical restraint? The short answer is

> `both of the above'. For more than half a century,

> separate lines of research have built strong empirical

> support for each position. Readers of this specialty

> journal will be familiar with the case against extreme

> CR.1

> As clinicians, we plead it daily to our anorexic

> patients; as researchers, we add more evidence to

> the file with every investigation. Yet as a field, we

> have remained surprisingly ignorant of the oppos-ing

> brief on behalf of semi-starvation. According to

> scientists who study caloric restriction for longevity

> (CRL), individuals with AN are basically on the

> right track for the wrong reason. When drastic calo-ric

> cutbacks are imposed on laboratory animals, spe-cies

> ranging from flies and fish to mice and monkeys

> all thrive (at least physically) on nutrient-dense

> deprivation (Masoro, 1988; et al., 2001; Roth,

> Ingram, & Lane, 2001; Weindruch & Walford, 1988).

> The most striking pay-offs are delayed senescence

> and increased lifespan—in some instances, nearly

> doubling the maximal age at death relative to nor-mally

> fed controls. The CRL effect holds for animals

> that start out thin, fat or average weight, and is most

> pronounced at the lowest level of intake compatible

> with survival. The regimens used in such research,

> then, are not just slimming diets for inactive, overfed

> mice languishing in the laboratory; subjects on CR

> reach the rodent equivalent of the anorexic zone.

> Growth is retarded, body temperature is depressed,

> fertility is impaired—yet on virtually every index

> considered by the CRLfield, the semi-starved organ-ism

> is better off in consequence.

> Onthe strength of these findings, CRL experts pre-dict

> that tremendous benefits would accrue if people

> could be persuaded to start undereating between the

> ages of 18 and 30 and remain hungry throughout

> their adult lives. Pilot research using human recruits

> was recently initiated in the United States, with

> funding from the National Institutes of Health. Some

> scientists are so confident of the results that they

> have already assigned themselves to a CR condition,

> reducing their own caloric intake by as much as 40%.

> Asmall but growing cohort of lay pioneers is follow-ing

> their example. Unsurprisingly, most of those

> who attempt the regimen fail (or fall back on such

> modest dietary restraint that their behaviour is bet-ter

> described as `sensible eating' than CRL). Afew of

> the most fervid, however, are maintaining levels of

> intake and weight consistent with laboratory ani-mals

> on CR—or patients with AN. Little is known

> about these freelance restricters, but the bits of infor-mation

> available fulfill the predictions of both the

> CRL and ED fields. Short-term physiological

> changes conform to those seen in underfed rodents

> that survive to great age in excellent health (Fontana,

> Meyer, Klein, & Holloszy, 2004). On the other

> hand, the psychological and behavioural effects

> resemble symptoms of AN, including food preoc-cupation,

> binge eating, social withdrawal, loss of

> libido, extreme obsessionality, cultivated food pho-bias,

> and the emergence of feelings of `specialness'

> and superiority for the triumph of will over appetite

> (Manke & Vitousek, 2002).

> Clearly, the two groups of researchers studying

> different aspects of CR need to become better

> acquainted. For a variety of reasons, it is incumbent

> on ED experts to take the lead in breaking through

> the artificial boundaries that have kept these scienti-fic

> communities isolated and inbred. The papers in

> this series were written to facilitate that objective.

> The first and second summarize the vast animal lit-erature

> on CRL, reviewing both the beneficial conse-quences

> that are featured by investigators and the

> deleterious effects that are obscured. The initial arti-cle

> (Vitousek, Gray, & Grubbs, this issue) provides a

> primer on the basics of CRL for an ED audience, out-lining

> the protocols used and the physiological

> changes they produce. The paper also highlights

> the importance of considering the context within

> which CR occurs, comparing underfeeding in the

> laboratory to human restriction in the Biosphere 2

> project and instances of AN. The second article

> examines what the CRL field does—and mostly

> doesn't—know about the behavioural, social, cogni-tive

> and affective consequences of deprivation

> (Vitousek, Manke, Gray, & Vitousek, European Eat-ing

> Disorders Review, in press). Researchers have

> shown little interest in these domains; however,

> the available evidence indicates that nutrient-dense

> CR in animals—just like nutrient-poor semi-starva-tion

> in people—is associated with numerous

> adverse effects. A third paper (Vitousek, Gray, &

> Talesfore, in press) addresses human applications

> of the paradigm, with specific proposals for

> increased collaboration—as well as confronta-tion—

> between the ED and CRL areas.

> WHAT'S IN IT FOR THE ED FIELD?

> At first pass, it is easier to see what ED experts can

> offer CRL researchers than to recognize what they

> can do for us—at least in any positive sense. We

> have considerable knowledge about failed and `suc-cessful'

> restriction in the species they are beginning

> to study, and some insight into what it takes to semi-starve

> outside the laboratory. A subset of our

> patients could also provide preliminary data about

> the physiology and health outcomes of chronic

> human CR, decades before more satisfactory

> answers might be obtained through controlled

> research (Vitousek, Gray, & Talesfore, in press).

> Indeed, two recent studies have already reported

> that a history of ANdecreases subsequent risk of car-diovascular

> disease (Korndorfer et al., 2003) and

> breast cancer (Michels & Ekbom, 2004), supporting

> the CRL view that semi-starvation can be construed

> as preventive medicine.

> By contrast, the most obvious effect of the CRL

> movement on our own work will be to make it more

> difficult. The scientific endorsement of semi-starvation

> will be confusing to many of our patients

> and exploited by some; certainly, it will muddle our

> message about the futility of dieting by the normal

> weight. We do not need to sound the alarm, how-ever,

> about a looming epidemic of CRL in the gen-eral

> population. Americans have boosted their

> intake an estimated 300–500 kcal/day over the last

> 30 years (Putnam, 1999; United States Department

> of Agriculture, 2002), despite a barrage of publicity

> about the relationship between overeating and pre-mature

> death. Publicity about the linkage between

> undereating and postponed death is unlikely to

> send millions charging in the opposite direction. If

> visions of immortality do inspire some people to

> trim back caloric excess, it may be good for their

> health—but it will not be CRL. Presumably, we

> cannot expect to shatter the lifespan barrier simply

> by eating 300 fewer calories per day if we are cur-rently

> eating 300 more than the generation that pre-ceded

> us.

> For the few who attempt the real thing, however,

> ED specialists would forecast less favourable out-comes.

> Far more will be left with a legacy of binge

> eating, increased adiposity and unwarranted guilt

> over the abandonment of extreme CR than will see

> their 130th birthdays. The rare individual who gets

> into the swing of semi-starvation will do so by pick-ing

> up the monotonous rhythms and rituals of

> restricting AN.All the evidence suggests that radical

> CR is incompatible with a life—of whatever dura-tion—

> that is genuinely lived `at liberty' (Vitousek,

> Gray, & Grubbs, this issue).

> Yet within these disheartening prospects, the CRL

> movement affords some extraordinary opportu-nities

> to our specialty area (Vitousek, Gray, &

> Talesfore, in press). While few ED experts would

> endorse the adoption of CRL by people—within or

> outside the context of research—we would be foolish

> to ignore an emerging phenomenon that we oppose

> but cannot control. Because semi-starvation affects

> so many aspects of functioning, efforts to decode

> the physiology and psychology of AN have always

> been hampered by the lack of an appropriate com-parison

> group. When we detect peculiar neuropep-tide

> levels or distinctive cognitive styles in

> individuals with AN, we cannot sort out the signifi-cance

> of those findings by comparing our patients to

> normal, psychiatric, or even dieting controls. The

> only satisfactory match for an otherwise healthy

> anorexic person with a BMI of 16 is an otherwise

> healthy non-anorexic person with a BMI of 16. For

> all the reasons reviewed in this series of articles, the

> latter virtually never occurs in nature—but does,

> very rarely, occur through freelance CRL. For the

> first time since the Minnesota Study (Keys et al.,

> 1950), we have the opportunity to observe sustained

> semi-starvation in presumably normal individuals

> leading more or less ordinary lives in peaceful and

> prosperous societies.

> In addition to the research opportunities afforded

> by CRL, the phenomenon may also help us see a

> familiar disorder from a fresh perspective. In cases

> of extreme CRL, we are witnessing the emergence

> of eerily `anorexic' beliefs and behaviours in indivi-duals

> (such as middle-aged males) at close-to-zero

> risk for a conventional ED (Manke & Vitousek,

> 2002; Vitousek, Gray, & Talesfore, in press). More-over,

> we can often trace the origin of their stereo-typed

> symptoms to a specific idea to which they

> were exposed at an identifiable point in time and

> resolved to pursue consciously and purposefully.

> In their view, the costs of chronic CR are justified

> by its anticipated rewards—and many sane, serious

> scientists agree. In other words, the identification of

> a different reason for semi-starvation shifts the popu-lation

> `at risk' and changes assessments of its ration-ality.

> Patterns that appear mysterious and

> pathological in the context of ANcan be seen as sen-sible,

> even admirable, in the service of goals that

> observers understand and endorse.

> Our own view is that both the pursuit of thinness

> and the pursuit of longevity are insufficient bases for

> radical restraint; however, if the example of CRL can

> illuminate the power of personally compelling

> motives for disordered eating, the ED field will ben-efit

> from giving it more thoughtful attention.

> REFERENCES

> Fairburn, C. G., & Brownell, K. D. (Eds.), (2002). Eating

> disorders and obesity: A comprehensive handbook. New

> York: Guilford Press.

> Fontana, L., Meyer, T. E., Klein, S., & Holloszy, J. O.

> (2004). Long-term calorie restriction is highly effective

> in reducing the risk for atherosclerosis in humans.

> Proceedings of the National Academy of Sciences, 10, 6659–

> 6663.

> Garner, D. M. (1997). Psychoeducational principles in

> treatment. In D. M. Garner, & P. E. Garfinkel (Eds.),

> Handbook of treatment for eating disorders (2nd ed.) (pp.

> 145–177). New York: Guilford Press.

> Keys, A., Brozek, J., Henschel, A., Mickelsen, O., & ,

> H. L. (1950). The biology of human starvation (2 vols).

> Minneapolis, MN: University of Minnesota Press.

> Korndorfer, S. R., Lucas, A. R., Suman, V. J., Crowson,

> C. S., Krahn, L. E., & Melton, L. J. III (2003). Long-term

> survival of patients with anorexia nervosa: A popula-tion-

> based study in Rochester, Minn. Mayo Clinic

> Proceedings, 78, 278–284.

> Manke, F. P., & Vitousek, K. M. (2002). Comment:

> Hunger, semi-starvation, and ill-health. American

> Psychologist, 57, 371–372.

> Masoro, E. J. (1988). Food restriction in rodents: An

> evaluation of its role in the study of aging. Journal of

> Gerontology: Biological Sciences, 43, B59–B64.

> Michels, K. B., & Ekbom, A. (2004). Caloric restriction and

> incidence of breast cancer. JAMA, 291, 1226–1230.

> Polivy, J. (1996). Psychological consequences of food

> restriction. Journal of the American Dietetic Association,

> 96, 589–592.

> Putnam, J. (1999). U.S. food supply providing more food

> and calories. Food Review, 22, 2–12.

> , S. B., Pi-Sunyer, X., Kuller, L., Lane, M. A.,

> Ellison, P., Prior, J. C., et al. (2001). Physiologic effects

> of lowering caloric intake in nonhuman primates and

> nonobese humans. Journals of Gerontology (Series A),

> 56A, 66–75.

>

>

> Cheers, Alan Pater

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>>>

From: " rwalkerad1970 " <rwalkerad1970@y...>

Date: Tue Oct 26, 2004 10:53 am

Subject: Re: What is extreme CR?

.... CR is all about Calories and Optimum

Nutrition, weight will sort itself out and if it gets to low your

doctor will say.

.... To me dean seemed to

start at a good weight/look, then got thin then ended up looking

anorexic (but I am not saying he is anorexic, but I certainly would

not want to look like that, it looks too fragile). He eats around

1800 cals a day (and is total vegan having recently given up whey)

http://deanpomerleau.tripod.com/pictures/index.htm

===

From: " jwwright " <jwwright@e...>

Date: Tue Oct 26, 2004 11:11 am

If I visit my doc looking like 7/27/00, she will think I have cancer

or a heart attack (experience). Subjective is a lot of what a doc

uses. Dean uses 2000 kcals. Dean's program is NOT what I will use

(gut feeling). I may look like that at 100 yo.

===

From: " Rodney " <perspect1111@y...>

Date: Tue Oct 26, 2004 2:52 pm

Subject: Re: What is extreme CR?

.... BF% is likely to be a safer measure to

use to determine CR weight targets than BMI. Or at least it would be

if we knew where we are supposed to be aiming for. And if we can be

confident we can rely on the method for measurement of BF%.

>>>

On the subject of Dean P.: Whereas Dean started from 170 lb, I

started from 167 lb. My diet is basically a Zone diet (30P/30F/40C) of

2000 calories. I arrived at 2000 calories as the right number of

calories for me by what I think is an " objective " method -- I

calculated my caloric requirement using the -Benedict equation

based on my height, weight, and age, multiplied by my activity factor

which includes 30 minutes per day of weight-bearing exercise. The

calculation gave my caloric needs as 2235 kcal, and applying a 10% CR

I ended up with a 2000-calorie diet.

My results are quite different from Dean. Here is how I looked last

year, at age 61, when I weighed 156 lb (BMI 23.8) and 14.2%BF.

http://www.scientificpsychic.com/fitness/az61a.jpg

I have stabilized around 151 lb (BMI 23.0) and 13.2% Body Fat. I will

be posting my age-62 picture around thanksgiving.

I tend to agree with Rodney that percent of body fat may be a good

indicator of where you are in CRON.

The American Council on Exercise has these classifications for Body

Fat:

.. . . . . . . . . . Women . . . . Men

Essential fat . . . 10-12% . . . 2-4%

Athletes . . . .. . 14-20% . . . 6-13%

Fitness . . . . . . 21-24% . . . 14-17%

In Message 14169 I posted equations that predict Lean Mass gain/loss

based on your initial fat weight. Once you are in the " fitness "

range, any weight losses will include a significant amount of muscle,

not only fat.

Tony

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Hi Tony:

I got a " Page Cannot be Found " error message at that

scientificpsychic link. jfi

Rodney.

>

> >>>

> From: " rwalkerad1970 " <rwalkerad1970@y...>

> Date: Tue Oct 26, 2004 10:53 am

> Subject: Re: What is extreme CR?

> ... CR is all about Calories and Optimum

> Nutrition, weight will sort itself out and if it gets to low your

> doctor will say.

> ... To me dean seemed to

> start at a good weight/look, then got thin then ended up looking

> anorexic (but I am not saying he is anorexic, but I certainly would

> not want to look like that, it looks too fragile). He eats around

> 1800 cals a day (and is total vegan having recently given up whey)

> http://deanpomerleau.tripod.com/pictures/index.htm

> ===

> From: " jwwright " <jwwright@e...>

> Date: Tue Oct 26, 2004 11:11 am

> If I visit my doc looking like 7/27/00, she will think I have cancer

> or a heart attack (experience). Subjective is a lot of what a doc

> uses. Dean uses 2000 kcals. Dean's program is NOT what I will use

> (gut feeling). I may look like that at 100 yo.

> ===

> From: " Rodney " <perspect1111@y...>

> Date: Tue Oct 26, 2004 2:52 pm

> Subject: Re: What is extreme CR?

> ... BF% is likely to be a safer measure to

> use to determine CR weight targets than BMI. Or at least it would be

> if we knew where we are supposed to be aiming for. And if we can be

> confident we can rely on the method for measurement of BF%.

> >>>

>

> On the subject of Dean P.: Whereas Dean started from 170 lb, I

> started from 167 lb. My diet is basically a Zone diet (30P/30F/40C)

of

> 2000 calories. I arrived at 2000 calories as the right number of

> calories for me by what I think is an " objective " method -- I

> calculated my caloric requirement using the -Benedict equation

> based on my height, weight, and age, multiplied by my activity

factor

> which includes 30 minutes per day of weight-bearing exercise. The

> calculation gave my caloric needs as 2235 kcal, and applying a 10%

CR

> I ended up with a 2000-calorie diet.

>

> My results are quite different from Dean. Here is how I looked last

> year, at age 61, when I weighed 156 lb (BMI 23.8) and 14.2%BF.

> http://www.scientificpsychic.com/fitness/az61a.jpg

>

> I have stabilized around 151 lb (BMI 23.0) and 13.2% Body Fat. I

will

> be posting my age-62 picture around thanksgiving.

>

> I tend to agree with Rodney that percent of body fat may be a good

> indicator of where you are in CRON.

> The American Council on Exercise has these classifications for Body

> Fat:

>

> . . . . . . . . . . Women . . . . Men

> Essential fat . . . 10-12% . . . 2-4%

> Athletes . . . .. . 14-20% . . . 6-13%

> Fitness . . . . . . 21-24% . . . 14-17%

>

> In Message 14169 I posted equations that predict Lean Mass gain/loss

> based on your initial fat weight. Once you are in the " fitness "

> range, any weight losses will include a significant amount of

muscle,

> not only fat.

>

> Tony

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Hi JR:

Can you suggest which markers you think would be the most revealing?

I.E. those one should pay the closest attention to.

Rodney.

--- In , " " <crjohnr@b...>

wrote:

> I would advise caution about assuming BMI or %BF can provide a

> simple safe lower limit for restriction. Probably the safest

> advice for any in doubt is to monitor blood markers for abrupt

> changes or outliers ............

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Hi, Francesca--

"Toying" with you? No, honestly, not at all. I'm trying to come to a clear understanding of what is meant by "extreme CR," and the people on this list are not the only ones I have asked this question of. I'm actually a little surprised by your comment. Isolating individual arguments and trying to understand how they hold up is hardly "toying" with someone. On the contrary, it's part of a process of attempting to arrive at an understanding of the truth, however elusive that may be.

As it happens, I have noticed that the terms "extremism," "extremist," and "extreme CRON" are used so frequently on this list--and often, seemingly, in different senses--that I wanted to arrive at the most commonly accepted concept of what this means to people. That was my whole motivation.

No, in fact, when you say, "I know it when I see it," that DOES seem subjective. To put it plainly, the more I think about the issue, I realize I have the vague notion that "extreme CR" MAY be most commonly used to refer to a percentage of CR. So, for example--using numbers pulled entirely arbitrarily out of my head--perhaps we would have the following:

MILD CR < / = 10% CR

10 % CR < MODERATE CR < / = 35 % CR

35 % CR < EXTREME CR

(As I said above, these figures are arbitrary and are given only by way of example of what some people may mean.)

Or would "extreme CR" be greater than or equal to 40 % CR? Or more?

I think someone somewhere probably has some more concrete ideas about this. But I also imagine there might be some sort of consensus on a general range--perhaps terms defined in specific studies?

In any case, if this is the criterion, would a person doing over 35 % or 40 % CR be doing extreme CR, even if that person had a stable weight at that rate and a BMI that is above 18 (your suggested cutoff point)? At that point, what would "extreme CR" mean? Asking the question is not mean to be "toying" with you. The answer that comes to mind is that the term MIGHT refer purely to the percentage CR without any consideration of other factors, specifically given the notion that the percentage CR may have a direct bearing on longevity. Again, I'm asking the question, not providing any real answer. But that answer is the only one that occurs to me.

Excuse me if that longwinded exposition seems like "toying" with you. The whole thing was meant honestly, as a set of questions I thought people could help me out with. You, Francesca, are the list moderator, so your comment strikes me as quite a rebuke--something I might entirely disregard from someone else.

Francesca Skelton <fskelton@...> wrote:

The "know it when I see it" argument is used universally. When you watch TVand see starving children it's pretty obvious they're starving; when the doc(or anyone) says: "Oh my you've lost too much weight" etc. So YOU may thinkit subjective, but the rest of the world is very comfortable with it.See my yesterday's post about vegetarianism and cutting out a whole foodgroup. I addressed that argument that principles, ethics and allergies arenot extremism IMO.I agree with Apricot that you seem to be toying with us and trying toprovoke us.on 10/26/2004 1:45 AM, ONeill at uptownguy34@... wrote:> Hi, Francesca--> > The "I-know-it-when-I-see-it" argument makes me nervous. It seems a bit too> subjective.> > If you see a six-foot tall male "weighing 115

pounds or so," is that a cutoff> point? That's a BMI roughly of 15.63. On the other hand, do you really mean "a> very thin man"? That seems a bit subjective also. For example, I've been> called extremely thin by some of my friends, and one has even expressed shock> at my thinness. However, I have a BMI above 19, and my doctor thinks I'm "in> really good shape." So when you say, "I know it when I see it," I'm a bit> skeptical.> > Is extreme CR something that has resulted in an eating disorder? I'm referring> to your examples of bulimia and anorexia. These conditions have specific> criteria and can be diagnosed. I would think they are different from CR per> se, and I also imagine that 99 percent of us do not have an eating disorder.> Though I may be wrong: it may be as low as 98 percent.> > I'm really not sure about your example of cutting out a whole food group.> Vegetarians

obviously come to mind. Also, many people on SAD have cut out at> least 1 food group without thinking about it as such, just because of personal> taste. My mother, for example, can't stand most dairy products, but she's not> lactose intolerant. She will consume them from time to time, but she gets any> dairy at all only on rare occasions. She's quite old and has no problems of> bone mass.> > I suppose my real problem with the whole question is that since we tend to> insist more on scientific judgments and criteria, the question of "extreme CR"> seems a bit too undefined--unless there is a common definition I'm simply> unaware of.> > > > > Francesca Skelton <fskelton@...> wrote:> Here's some of my definitions of "extremism" YMMV:> > Six foot tall males weighing 115 pds or so.> > Not being able to go on a family vacation

without preparing/taking coolers> and coolers of CRONIE food.> > Sampling high calorie/rich foods, then spitting out (the beginnings of> bulemia?). Done in secret, and hiding from family/friends.> > Any extreme cutting of calories/behavior leading to anorexia/bulemia or an> eating disorder.> > CRON becoming the entire "raison d'etre" for existing rather than doing CRON> to exist better/longer. Your entire life revolving around all things CRON.> > Cutting out an entire food group such as all whole grains (unless you're> allergic) extreme.> > Just a few real life examples. Like porn: I know it when I see it.> > As mentioned, I could be wrong. In 100 years or so we'll find out> .....unless some of us start dropping like flies before that........> > > > > on 10/25/2004 5:53 PM,

uptownguy34 at uptownguy34@... wrote:> >> >> People often refer to "extremism" on this list, and "extreme CR">> or "extreme CRON" is typically condemned. Still, I'm not sure what>> this means. >> >> Is getting a very low level of calories "extreme CR"? If so, where's>> the cutoff point? Would it be 1,500 for men? 1,000 for women?>> Wouldn't it have to depend on your height and weight, along with the>> rate at which you typically lose weight?>> >> Is eliminating a whole food group "extreme CR"? If so, then are all>> vegans and vegetarians on this list doing "extreme CR"? Do we really>> want to label vegetarians "extremists"? I wouldn't. (Note that I>> myself will eat almost anything, with the exception of things I>> simply can't stomach or products containing trans-fats or too much>> saturated fat. The quantity of

"borderline" items I consume depends>> on my assessment of how detrimental they could be to my health.)>> Besides, CR (or CRON, if you prefer) is not, in my understanding of>> it, a prescriptive diet. You create your own diet on the basis of>> principles of optimal or at least adequate nutrition, and you lower>> your calorie intake by an amount you determine. Naturally, it's best>> not to give your body a shock by cutting your calories by 50 percent>> overnight.>> >> Is having a very low BMI an automatic determiner of "extreme CR"?>> Well, I can think of one individual--who shall remain unnamed--who>> has, at times, been used on this list as an example of extremism and>> who does indeed have a very low BMI. But what is someone who begins>> CR with a low BMI to do, especially if that person truly believes>> that CR will lead to greater health and

longevity? Just give up on>> the idea entirely, because CR will lead to an even lower BMI? That>> doesn't seem a reasonable recommendation.>> >> Is pushing CR to the point of doing damage to one's health what you>> would call "extreme CR"? That sounds more reasonable, but one>> plausible explanation is that anyone who does so has simply>> practiced CR badly and may since have recognized the error of his or>> her ways. It's a tricky thing, after all. Why else would there be so>> much debate about the benefits of fish, grains, and ALA, just to>> cite a few examples, if "optimal nutrition" were a clear-cut issue?>> It is not. The general outlines are more or less clear, but much>> remains to be learned, as we all know. Therefore, it is absolutely>> understandable that one may do damage to one's health in the process>> of doing CR--even without

intending to push things to extremes. I am>> aware of a number of instances of this, and it's something that all>> CR novices should be aware of.>> >> I suppose I might consider the last point to be an example of>> extreme CR if an individual pushed things to the point of serious>> health damage and stubbornly refused to change. Still, it might be>> more accurate to refer to such practices as "eating disorders" or,>> as the case may be, "anorexia.">> >> So what do you think? Personally, I wonder whether my own CR would>> be considered "extreme" by some on your list--not that I would feel>> insulted, mind you.>> >> I'll be interested to read people's responses to this topic.>> >> > __________________________________________________

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Dear and others: I apologize if I made a wrong accusation.

See my previous posts on the subject. That's the best I can do. If I, Jr,

Citpeks and Rodney haven't clarified it enough for you, I guess you'll just

have to come to your own " definition " .

I am human just like everyone else.

on 10/26/2004 4:41 PM, ONeill at uptownguy34@... wrote:

>

> Excuse me if that longwinded exposition seems like " toying " with you. The

> whole thing was meant honestly, as a set of questions I thought people could

> help me out with. You, Francesca, are the list moderator, so your comment

> strikes me as quite a rebuke--something I might entirely disregard from

> someone else.

>

>

>

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Hi All,

Yes, the pdf is available off-list.

I just would need to fish it out of my garbage file.

Cheers, Al Pater.

>

> This is hard to read do you have links to original sources?

>

> --- In , " old542000 " <apater@m...>

wrote:

> >

> > --- In , " citpeks " <citpeks@y...>

wrote:

> > >

> > > >>>

> > > From: " uptownguy34 " <uptownguy34@y...>

> > > Date: Mon Oct 25, 2004 5:53 pm

> > > Subject: What is extreme CR?

> > > >>>

> > >

> > > There is a series of three papers by Vitousek, et. al,

from

> > the

> > > department of psychology, University of Hawaii, that portray

caloric

> > > restriction as an anorexic lifestyle called the " CR syndrome " .

The

> > > authors say that Walford put a positive spin on food

deprivation and

> > > understated the degree of hunger and deprivation in the

Biosphere.

> > > The authors even used some of the postings on the

> > > calorierestriction.org web site as references to document the

> > reduced

> > > libido and other physical problems of CR practitioners.

According

> > to

> > > the author, " To eating disorder (ED) specialists, severe caloric

> > > restriction (CR) is a symptomatic behaviour. When sustained for

> > years,

> > > it imposes grave consequences on the few troubled people who

> > persist. "

> > >

> > > What can we learn from this? 1) What you post can be used

against

> > you

> > > in unexpected ways. 2) CR is viewed as something abnormal

practiced

> > by

> > > people with some mental compulsion or disorder.

> > >

> > > Tony

> > >

> > > ===

> > >

> > > European Eating Disorders Review, 12, Issue 5

(September/October

> > 2004)

> > > Caloric restriction for longevity: I. Paradigm, protocols

> > > and physiological findings in animal research (p 279-299)

> > > M. Vitousek, A. Gray, Kathleen M. Grubbs

> > >

> > > Caloric restriction for longevity: II - The systematic neglect

of

> > > behavioural and psychological outcomes in animal research.

> > > M. Vitousek, Frederic P. Manke, A. Gray, Maren N.

> > > Vitousek, Eur. Eat. Disorders Rev. 12, 338–360 (2004)

> > >

> > > The case for semi-starvation (p 275-278)

> > > M. Vitousek, Published Online: 26 Aug 2004

> >

> >

> > Hi All,

> >

> > M. Vitousek does throw a challenge to CRers in the below.

> >

> > Note the references to the CR Society file archives for Dean P

and

> > Sherm.

> >

> > There is a huge amount of information that may be swamped by

> > presenting the three below pdfs in full, but the three-page

overview

> > may somewhat suffice.

> >

> > The pdfs are available as is the in press one below.

> >

> > European Eating Disorders Review, 12, Issue 5

(September/October

> > 2004)

> > Caloric restriction for longevity: I. Paradigm, protocols

> > and physiological findings in animal research (p 279-299)

> > M. Vitousek, A. Gray, Kathleen M. Grubbs

> > Published Online: 26 Aug 2004

> > DOI: 10.1002/erv.594, Full Text: PDF (Size: 192K)

> > ... Across the CRL literature, there is a

> > conspicuous silence about the loss of libido expected

> > in both males and females on significant dietary

> > restriction.

> > Cold Intolerance

> > Organisms on CR become frigid in a literal sense as

> > well.

> > ...1

> > Acronyms abound in the field of caloric restriction for

> > longevity. Like other movements with a public relations

> > problem, it seems to be searching for a label that projects a

> > more positive image. A sampler of the terms tried out

> > includes: caloric restriction (CR), dietary restriction (DR),

> > food restriction (FR), energy reduction (ER), caloric restriction

> > with adequate nutrition (CRAN), caloric restriction with

> > optimal nutrition (CRON), hypocaloric diet, high-quality

> > low-calorie diet, and undernutrition without malnutrition.

> > We use `CR' to denote generic calorie restriction (which can

> > apply to involuntary food deprivation, dieting, anorexic

> > eating patterns, or the regimen advised by researchers in this

> > area); we use `CRL' to refer more narrowly to the field and the

> > practice of caloric restriction for longevity.

> > ...2

> > CR cannot be absolved from making some contribution to

> > the AN suicide statistics, in view of the association between

> > food deprivation and depression in normal individuals

> > (Keys, Brozek, Henschel, Mickelsen, & , 1950); in

> > addition, many AN patients link their suicidal ideation to

> > despair over the constricted life required by CR and self-loathing

> > for their inability to sustain it. It is probable,

> > however, that pre-existing psychopathology (quite likely

> > exacerbated by CR) explains most of the variance in deaths

> > by suicide. It is more awkward to contend that the negative

> > effects of bulimia should not count as direct costs of CR. Binge

> > eating is a lawful response to caloric insufficiency, and

> > purging a predictable reaction to its occurrence in people

> > committed to caloric control.

> > ...3

> > If our suggestion that AN patients might be encouraged to

> > replace haphazard CR with proper CRL seems far-fetched,

> > the following post to the CR Society listserve is instructive:

> > `[CR practitioners should] reach out to specific groups who

> > might derive serious benefit from [CR] member-ship

> > ...[including individuals with] anorexia or bulemia

> > [sic]. [We] can take these people in, not telling them that

> > they are ill, but rather informing them that thinness is not

> > only OK, but desirable ...They can be taught that both goals

> > [i.e. thinness and health] can be met together, and that they

> > will stay young and beautiful many extra years by [ensuring

> > adequate nutrition on a CRL regimen]. Instead of going to

> > therapy to deal with their mental aberration, they will attend

> > [CR support groups] to encourage their desire in a healthy

> > direction' (`Adzoe', 2002). Our own recommendation for the

> > fine-tuning of anorexic restriction is rhetorical; this corre-

spondent

> > seems disturbingly sincere.

> > ... 4

> > Consistent with the positive spin placed on every aspect of

> > life on CR, Walford repeatedly maintains that the Bio-spherians

> > `were not overly hungry' and `did not feel undue

> > hunger' while on their restricted regimen (Walford &

> > Walford, 1994, pp. 20, 24, 29). All the accounts we have

> > located from Walford's fellow team members contradict his

> > characterization of their experience. For example, Silverstone

> > (1993) indicated that `hunger was an almost constant

> > companion', (in kson, 1993) that `hunger was a

> > nearly constant, nagging presence', Alling and (1993)

> > that `hunger [was] ...always there to struggle against' and

> > Leigh (Associated Press, 1996) that `[it] made us all a little

> > cranky, always being hungry'. The classic semi-starvation

> > phenomena that emerged in Biosphere 2—including food

> > fantasizing, maximizing, hoarding, stealing, massing, sub-

stitution

> > habits and mistrust of others over the distribution of

> > rations—are also inconsistent with the claim that participants

> > `were not overly hungry'.

> > ... Anorexia Nervosa

> > The second example comes from our own specialty

> > area: the observation of patients with chronic, rela-tively

> > stable AN. If rodents and primates allocated

> > to a CR condition are the most fortunate of labora-tory

> > animals, these individuals hold the winning

> > ticket in the human species. Through their own

> > initiative—albeit for different reasons—they have

> > found their way to a dietary regimen that should

> > be associated with unprecedented health, vigour

> > and longevity.

> > In some senses, individuals with longstanding AN

> > make even better exemplars of human CRL than the

> > tiny sample of enclosed Biospherians. Their exis-tence

> > affirms that at least a few people can practise

> > radical restriction at liberty; their persistence means

> > that wecan trace its effects over much longer periods

> > than the token 2-year stint in Biosphere 2. Of course,

> > only a fraction of AN patients will meet criteria for

> > correct CR over time, and their compliance cannot

> > be verified with precision. Experts stress, however,

> > that the critical element in the CRL paradigm is

> > simply prolonged caloric deficit in the absence of

> > malnutrition. Some AN patients clearly fulfill those

> > specifications. So what can this subgroup of indivi-duals

> > tell us about serious, sustained CR outside the

> > context of the laboratory?

> > One ready conclusion is that CR does indeed

> > `work' for human beings, at least in the same limited

> > sense affirmed by the Biosphere data. CRL advo-cates

> > were excited (if not surprised) when food

> > restriction was shown to lower the blood pressure,

> > body temperature, glucose levels and white cell

> > counts of the eight Biospherians. Precisely the same

> > results can be read off the medical charts of thou-sands

> > of AN patients. (Moreover, such benefits are

> > discernible not only in the model cases who adopt

> > nutritionally sound CR, but the considerably larger

> > percentage of patients who practise unsanctioned

> > forms of restriction—although the animal research

> > predicts that only the former will enjoy the full array

> > of long-term benefits.) Two recent datasets also offer

> > tantalizing hints about the potential protective

> > power of prolonged CR. In one records-based study

> > of patients with possible, probable or definite AN

> > seen up to 63 years earlier, the total sample appeared

> > at heightened risk of death from psychiatric causes,

> > including suicide and alcoholism; however, all-cause

> > mortality was not elevated and there was a

> > decreased risk of death from cardiovascular disease

> > (Korndorfer et al., 2003; see discussions in Palmer,

> > 2003, and Sullivan, 2003). Because of diagnostic

> > uncertainties and lack of information about diet

> > and duration, these findings are no more than sug-gestive.

> > But through the noise of methodological

> > limitations, the signal that CRL researchers would

> > most like to discern emits a faint hum. Whatever

> > damage ANmay reflect and/or inflict in other areas

> > of patients' lives, it could be working wonders in

> > their circulatory systems—just as imposed CR

> > improves the cardiovascular health of underfed

> > rodents and monkeys. Another retrospective study

> > of 7303 women previously hospitalized for AN

> > found a 53% lower incidence of breast cancer over

> > the follow-up interval (Michels & Ekbom, 2004)—

> > ironically, almost precisely matching the risk reduc-tion

> > for mammary tumours in energy-restricted

> > mice (Dirx, Zeegers, Dagnelie, van den Bogaard, &

> > van den Brandt, 2003).

> > On the other hand, data from the ED field suggest

> > that CR virtually never `works', in the sense that it is

> > rarely sustained over time and generally done quite

> > badly—even by individuals who are fiercely

> > committed to keeping it running and doing it right.

> > Dieters regain, `restrained' eaters limit their intake in

> > theory more than practice, and a majority of restrict-ing

> > anorexics slide inexorably towards bulimia.

> > Quite commonly, AN patients find themselves

> > unable to continue hard-core restraint without ever

> > having made an affirmative decision to let it go.

> > After years—sometimes even decades—of grimly

> > `successful' CR, they can no longer summon the

> > strength required for the constant battle with their

> > own biology.

> > We can also learn more about the significance of

> > the silent terms in the CRL syllogism by analysing

> > how some AN patients manage to restrict as

> > valiantly and persistently as they do. At the start of

> > their disorder, the external circumstances of anor-exics-

> > in-the-making show little resemblance to those

> > of lab rats or Biospherians. By the time AN is well

> > established, however, most have recreated a

> > strikingly similar environment. In effect, anorexic

> > individuals construct their own virtual cages and

> > move in for the duration of their illness. Each finds

> > her way, individually but lawfully, to the same set

> > of conditions that researchers create for animals on

> > CR: isolation from others; protected, predictable

> > and constricted surroundings; minimal demands

> > or expectations; fixed and monotonous rations; elim-ination

> > of activities and goals incompatible with the

> > maintenance of CR. It seems probable that those are

> > the only circumstances under which severe restric-tion

> > can be practised or endured. For psychological

> > reasons, individuals with AN may be willing to pay

> > the astronomical costs of chronic deprivation that

> > less troubled people reject as unacceptable. Advo-cates

> > of CRL are urging the general public to recon-sider,

> > in view of the objective benefits to be gained

> > from an anorexic lifestyle. From our perspective, it

> > is fortunate that their efforts will seldom succeed

> > (Vitousek & Gray, 2002).

> > Recently, experts have begun to acknowledge that

> > CRL may not gain widespread acceptance (e.g.

> > Mattson et al., 2003; Pinel et al., 2000; Roth et al.,

> > 2001)—but they have yet to come to terms with

> > why that is so. Many seem to view the human reluc-tance

> > to semi-starve as a blend of ignorance, short-sightedness,

> > weakness and hedonism. Whatever

> > the merits of these models in explaining the steep

> > rise in obesity rates, they do not provide an adequate

> > account for the rejection of radical CR and subnor-mal

> > weight. To understand why Biospherians and

> > lab animals refeed the moment they are reprieved

> > from restriction—or why anorexics must retreat

> > from the world in order to pursue it —we need to

> > look to the CR syndrome itself. In addition to the

> > conservative biological changes that foster health

> > and longevity, the network of defensive reactions

> > to CR includes profound, predictable shifts in beha-viour,

> > cognition and affect. These neglected ele-ments

> > of the syndrome clarify why it can be

> > examined only in captive animals, enclosed Bio-spherians

> > and self-imprisoned individuals with

> > AN—and are the subject of the second paper in this

> > series (Vitousek, Manke, Gray, & Vitousek, European

> > Eating Disorders Review, in press).

> > ...REFERENCES

> > `Adzoe'. (2002). Proactive and bullish CR. Retrieved July 7,

> > 2003 from http://group./group/crsociety/

> > message 21136.

> >

> > Research Article

> > Caloric restriction for longevity: II - The systematic

> > neglect of behavioural and psychological outcomes

> > in animal research

> > M. Vitousek, Frederic P. Manke, A. Gray, Maren N.

> > Vitousek

> > Published Online: 21 Oct 2004

> > DOI: 10.1002/erv.604, Full Text: PDF (Size: 212K)

> > Eur. Eat. Disorders Rev. 12, 338–360 (2004)

> > Research on caloric restriction for longevity (CRL) has

generated

> > hundreds of articles on the physiology of food deprivation, yet

> > almost no data on consequences in other domains. The first paper

in

> > this series outlined the generally positive physical effects of

CRL;

> > the second analyses the meagre and sometimes disturbing record of

> > research on behaviour, cognition and affect. The available

evidence

> > suggests that nutrient-dense CRL in animals—just like nutrient-

poor

> > semi-starvation in people—is associated with a number of

> > adverse effects. Changes include abnormal food-related behaviour,

> > heightened aggression and diminished sexual activity. Studies of

> > learning and memory in underfed rodents yield inconsistent

> > findings; no information is available on cognitive effects in

> > primates. To date, the CRL field has ignored other variables that

> > are crucial to the human case and known to be disrupted by chronic

> > hunger, including sociability, curiosity and emotionality. Promo-

tion

> > of CRL for people is irresponsible in the absence of more

> > reassuring data on the full range of expected outcomes. Eating

> > disorder specialists should be contributing to scientific and

public

> > discussions of this increasingly prominent paradigm.

> > 1

> > Because of the instrumental quality of someof the behavioural

> > responses to CR, it is difficult to avoid metaphors suggesting

> > that they were ordained by a granddesign. We occasionally use

> > such language when referring to the adaptive value of the CR

> > syndrome, implying that Nature `wants' the semi-starving

> > organism to be food-obsessed, irritable and asocial; however,

> > we do recognize the fallacy of imputed intent. Nature is not

> > invested in how individuals (or, for that matter, whole species)

> > feel, function or fare. Animals that react to famine in these

> > selected ways are simply likely to out-compete animals that do

> > not, surviving to bear and rear similarly disposed progeny.

> > ...`There is a downside to caloric restriction, how-ever,

> > which is obvious even to a casual observer

> > who visits during mealtime. The monkeys go

> > crazy when the food shows up, grasping at their

> > meager rations'. (Weiss, 1997, p. 24)

> > ...`All monkeys walked more before feeding than

> > afterwards, but restricted monkeys paced twice

> > as much as controls prior to eating and six times

> > more after food was offered. Before feeding,

> > restricted monkeys also exhibited more threaten-ing

> > displays, and also cooing, than controls. The

> > restricted monkeys ate and drank more inten-sively

> > than controls after food was given to them'.

> > (Ramsey et al., 2000, pp. 1142–1143)

> > ...2

> > After this article was written, CRL researcher, popularizer

> > and practitioner Roy Walford died of amyotrophic lateral

> > sclerosis (ALS) at the age of 79. There is no basis for

> > speculating that his two decades on CR contributed to the

> > development of his disease—or that earlier or more stringent

> > CR could have prevented it. Although some obituaries noted

> > the discrepancy between his quite ordinary age at death and

> > his promotion of `the 120-year diet' (Walford, 1986, 2000),

> > Walford always emphasized (correctly) that his own long-evity

> > was merely a single data point in the study of human

> > CRL. He strayed from the evidence, however, when he

> > persisted on CR after the onset of his illness and credited the

> > diet for slowing its progression. An animal model of ALS

> > suggests that CR not only fails to protect against the disease

> > but accelerates its clinical course once it is underway

> > (Pedersen & Mattson, 1999).

> > ...Heaps of data show that animals on CR retain

> > their youthful vigour, avoid many diseases and

> > enjoy remarkably long lives—and if you make

> > the commitment to undereat for decades, YOU

> > CAN TOO!

> > Reviewers do not similarly connect the dots with

> > reference to sexuality. No summary article on CRL

> > includes a parallel statement that extrapolates the

> > bad news from animals to people:

> > Heaps of data show that animals on CR have

> > decreased levels of sex hormones, little interest

> > in mating, and impaired fertility—and if you

> > make the commitment to undereat for decades,

> > YOU CAN TOO!

> > ...`Although I had to steel myself when I first posted

> > my libido problems, it was amazing how many

> > other CR folks were suffering in silence. This is a

> > really serious issue, which Walford has swept

> > under the rug in his books'. (Sherman, 2000)

> > ...`You may have to give up angel food cake [on a CR

> > regimen], but to those for whom sight, sense, and

> > sexuality are less important than angel food cake, I

> > have nothing to offer ...If you must have a certain

> > measure of sin, I suggest you give up gluttony and

> > accentuate one of the [other seven sins]: lust, for

> > example. [Critics of CR] and all you other sinners,

> > give up gluttony and double your lust!' (Walford,

> > 1986, p. 30)

> > ...3

> > While cognitive function is also fairly well preserved in AN,

> > the picture is not benign in severely ill patients. Neurocog-

nitive

> > impairments and structural brain changes are often

> > detected (e.g. Kingston, Szmukler, es, Tress, &

> > Desmond, 1996; Lambe, Katzman, Mikulis, Kennedy, &

> > Zipursky, 1997; Mathias & Kent, 1998; Moser et al., 2003;

> > Swayze et al., 2003). Many (but not all) of these abnormalities

> > tend to reverse with weight restoration. It should not be

> > assumed that the same changes would occur on the

> > recommended CRL regimen; however, too little is known

> > about the mechanisms that produce them to rule out the

> > possibility of untoward effects, particularly in human

> > practitioners who reduce too fast, too far, or through resort

> > to disapproved techniques. The first published MRI study of

> > restricted monkeys determined that subjects on moderate,

> > nutritionally correct CR had lower volumes of the putamen

> > compared to controls, although the opposite pattern had been

> > predicted (Matochik et al., 2004); the significance of this

> > finding remains unclear in the early stages of primate

> > research.

> > ...` Roth ...who is testing the monkeys'

> > behavior, says progress is frustrating. ``It's taking

> > a long time to train the monkeys to do the tasks,''

> > he says. ``We hope to get faster, but it's agoniz-ingly

> > slow,'' and he has no results to report.'

> > (Devitt, 1998, p. 1)

> > ...`Clinically, anorexics do surprisingly well despite

> > their growing emaciation ...Far from being

> > lethargic, they are typically hyperenergized. Ser-ious

> > problems do not generally occur until 30

> > to 40 percent of [body weight] has been lost'.

> > (Weindruch & Walford, 1988, p. 303)

> > ...4

> > In the end, the funding agency blinked when it came to

> > supporting CRL research with young, normal-weight parti-cipants,

> > as advised by the Hass et al. (1996) panel, opting

> > instead to fund studies of middle-aged and older volunteers

> > who were overweight but not obese. We agree that this was a

> > more ethically sound decision; however, the results may yield

> > limited information about the potential of human CRL

> > (Vitousek, Gray, & Talesfore, European Eating Disorders

> > Review, in press). Such research will also underestimate the

> > costs of CR for normal-weight individuals. ED experts

> > disagree about whether dieting is advisable for people who

> > are overweight (see discussions in Brownell & Rodin, 1994;

> > , 2002; Garner & Wooley, 1991; McFarlane, Polivy, &

> > McCabe, 1999; Wadden, Brownell, & , 2002; ,

> > 2002). All concur, however, that CR by the underweight and

> > normal-weight elicits distinctive and much more negative

> > effects.

> > ...5

> > As noted in the companion article (Vitousek, Gray, &

> > Grubbs, 2004), recent evidence indicates that at least one

> > strain of mouse does enough catch-up eating on every-other-day

> > feeding schedules to maintain near-normal caloric intake

> > and weight—yet profits from the life extension bonus of CR

> > all the same (Anson et al., 2003). Apparently, restricting-subtype

> > AN is not the only eating disorder that may provide

> > health benefits. The general pattern associated with non-purging

> > bulimia nervosa can also be endorsed, as long as

> > fasting and binge eating are appropriately spaced and

> > adequate nutrition is assured. A different set of problems

> > arises, however, when the same organisms who are experien-cing

> > the CR regimen are also administering the CR regimen.

> > Individuals who intend to fast all day often fail to make it past

> > mid-afternoon before the bingeing begins. Once again,

> > proponents of CRL would do well to consult the ED field

> > about the foreseeable fate of intermittent feeding schedules in

> > free-ranging humans.

> > ...We anticipate that once CRL researchers do so,

> > they will be unable to make the case at all. It is

> > already clear—in part from research conducted

> > within the framework of CRL—that the food focus

> > and asexuality of semi-starvation are not mitigated

> > with micronutrients. There are insufficient data to

> > gauge whether consequences such as depression

> > will be reduced; it is a good guess that effects such

> > as decreased sociability and a narrowed scope of

> > interests will not. Indeed, it would be astonishing

> > if vitamin-enriched CRelicited the desired physiolo-gical

> > elements of the CRL syndrome while neatly

> > excising its inconvenient psychological compo-nents.

> > The vigorous behavioural, cognitive and

> > affective defences against undereating are not side-effects

> > but central effects of Nature's reaction to the

> > crisis of caloric deficit, as firmly embedded in the

> > `well-coordinated network' as changes on the cellu-lar

> > level. The physiology of CRL may be the pre-ferred

> > focus of specialists in this area, but the

> > phenomenon they have chosen to study does not

> > give them the freedom to pick and choose. The

> > CRL effect comes as a package deal for any organism

> > in which it is elicited; accordingly, it comes as a pack-age

> > deal for any investigator who hopes to describe,

> > understand or exploit it.

> > ...Pomerleau, D. (2000). [CR] Just do it! [Msg 6676]. Message

> > posted to CR Society electronic mailing list, retrieved

> > April, 2001, from www. infinitefaculty.org/sci/cr/

> > crs/2001_01.txt

> > ...Sherman, M. (2000). E-mail `Apology and testosterone

> > discussion', to crsociety list, June 1, 2000.

> >

> > Invited Article

> > The case for semi-starvation (p 275-278)

> > M. Vitousek

> > Published Online: 26 Aug 2004

> > DOI: 10.1002/erv.593, Full Text: PDF (Size: 58K)

> > University of Hawaii, USA

> > The papers in this series assume familiarity with the clinical

> > manifestations of AN and semi-starvation; for additional

> > background on these topics, see Fairburn and Brownell (2002),

> > Garner (1997), Keys, Brozek, Henschel, Mickelsen and

> > (1950) and Polivy (1996).

> > The eating disorder field has been slow to respond to the

pheno-

> > menon

> > of caloric restriction for longevity (CRL), currently a central

> > focus of research in biogerontology. On the basis of compelling

> > evidence that animals remain healthier and live longer on diets of

> > `anorexic' severity, some experts are recommending chronic self-

> > deprivation

> > to the general public. This brief article introduces a

> > series of papers on CRL, outlining the challenges and opportu-

nities

> > the movement presents to our speciality area. Keywords: caloric

> > restriction; dietary restriction; longevity; ageing; eating

disorders

> > To eating disorder (ED) specialists, severe caloric

> > restriction (CR) is a symptomatic behaviour. When

> > sustained for years, it imposes grave consequences

> > on the few troubled people who persist. Individuals

> > with anorexia nervosa (AN) often insist that they are

> > `healthy', but experts knowthat they are mistaken—

> > indeed, only through increased eating and weight

> > can they regain their health and begin to improve

> > their lives.

> > To a growing number of physiologists and geron-tologists,

> > severe CR is a miraculous paradigm and a

> > desirable goal. If practised for decades, it promises

> > extraordinary benefits to anyone with the wisdom

> > and self-discipline to persevere. The general public

> > may doubt that one can be `healthy' while eating

> > too little to support normal physiology and repro-duction.

> > Confidently, experts assure them that they

> > are mistaken—indeed, only through chronic under-eating

> > can they hope to retain their health and vigour

> > to the end of an unprecedented lifespan.

> > Which of these perspectives has the right take on

> > the merits of radical restraint? The short answer is

> > `both of the above'. For more than half a century,

> > separate lines of research have built strong empirical

> > support for each position. Readers of this specialty

> > journal will be familiar with the case against extreme

> > CR.1

> > As clinicians, we plead it daily to our anorexic

> > patients; as researchers, we add more evidence to

> > the file with every investigation. Yet as a field, we

> > have remained surprisingly ignorant of the oppos-ing

> > brief on behalf of semi-starvation. According to

> > scientists who study caloric restriction for longevity

> > (CRL), individuals with AN are basically on the

> > right track for the wrong reason. When drastic calo-ric

> > cutbacks are imposed on laboratory animals, spe-cies

> > ranging from flies and fish to mice and monkeys

> > all thrive (at least physically) on nutrient-dense

> > deprivation (Masoro, 1988; et al., 2001; Roth,

> > Ingram, & Lane, 2001; Weindruch & Walford, 1988).

> > The most striking pay-offs are delayed senescence

> > and increased lifespan—in some instances, nearly

> > doubling the maximal age at death relative to nor-mally

> > fed controls. The CRL effect holds for animals

> > that start out thin, fat or average weight, and is most

> > pronounced at the lowest level of intake compatible

> > with survival. The regimens used in such research,

> > then, are not just slimming diets for inactive, overfed

> > mice languishing in the laboratory; subjects on CR

> > reach the rodent equivalent of the anorexic zone.

> > Growth is retarded, body temperature is depressed,

> > fertility is impaired—yet on virtually every index

> > considered by the CRLfield, the semi-starved organ-ism

> > is better off in consequence.

> > Onthe strength of these findings, CRL experts pre-dict

> > that tremendous benefits would accrue if people

> > could be persuaded to start undereating between the

> > ages of 18 and 30 and remain hungry throughout

> > their adult lives. Pilot research using human recruits

> > was recently initiated in the United States, with

> > funding from the National Institutes of Health. Some

> > scientists are so confident of the results that they

> > have already assigned themselves to a CR condition,

> > reducing their own caloric intake by as much as 40%.

> > Asmall but growing cohort of lay pioneers is follow-ing

> > their example. Unsurprisingly, most of those

> > who attempt the regimen fail (or fall back on such

> > modest dietary restraint that their behaviour is bet-ter

> > described as `sensible eating' than CRL). Afew of

> > the most fervid, however, are maintaining levels of

> > intake and weight consistent with laboratory ani-mals

> > on CR—or patients with AN. Little is known

> > about these freelance restricters, but the bits of infor-mation

> > available fulfill the predictions of both the

> > CRL and ED fields. Short-term physiological

> > changes conform to those seen in underfed rodents

> > that survive to great age in excellent health (Fontana,

> > Meyer, Klein, & Holloszy, 2004). On the other

> > hand, the psychological and behavioural effects

> > resemble symptoms of AN, including food preoc-cupation,

> > binge eating, social withdrawal, loss of

> > libido, extreme obsessionality, cultivated food pho-bias,

> > and the emergence of feelings of `specialness'

> > and superiority for the triumph of will over appetite

> > (Manke & Vitousek, 2002).

> > Clearly, the two groups of researchers studying

> > different aspects of CR need to become better

> > acquainted. For a variety of reasons, it is incumbent

> > on ED experts to take the lead in breaking through

> > the artificial boundaries that have kept these scienti-fic

> > communities isolated and inbred. The papers in

> > this series were written to facilitate that objective.

> > The first and second summarize the vast animal lit-erature

> > on CRL, reviewing both the beneficial conse-quences

> > that are featured by investigators and the

> > deleterious effects that are obscured. The initial arti-cle

> > (Vitousek, Gray, & Grubbs, this issue) provides a

> > primer on the basics of CRL for an ED audience, out-lining

> > the protocols used and the physiological

> > changes they produce. The paper also highlights

> > the importance of considering the context within

> > which CR occurs, comparing underfeeding in the

> > laboratory to human restriction in the Biosphere 2

> > project and instances of AN. The second article

> > examines what the CRL field does—and mostly

> > doesn't—know about the behavioural, social, cogni-tive

> > and affective consequences of deprivation

> > (Vitousek, Manke, Gray, & Vitousek, European Eat-ing

> > Disorders Review, in press). Researchers have

> > shown little interest in these domains; however,

> > the available evidence indicates that nutrient-dense

> > CR in animals—just like nutrient-poor semi-starva-tion

> > in people—is associated with numerous

> > adverse effects. A third paper (Vitousek, Gray, &

> > Talesfore, in press) addresses human applications

> > of the paradigm, with specific proposals for

> > increased collaboration—as well as confronta-tion—

> > between the ED and CRL areas.

> > WHAT'S IN IT FOR THE ED FIELD?

> > At first pass, it is easier to see what ED experts can

> > offer CRL researchers than to recognize what they

> > can do for us—at least in any positive sense. We

> > have considerable knowledge about failed and `suc-cessful'

> > restriction in the species they are beginning

> > to study, and some insight into what it takes to semi-starve

> > outside the laboratory. A subset of our

> > patients could also provide preliminary data about

> > the physiology and health outcomes of chronic

> > human CR, decades before more satisfactory

> > answers might be obtained through controlled

> > research (Vitousek, Gray, & Talesfore, in press).

> > Indeed, two recent studies have already reported

> > that a history of ANdecreases subsequent risk of car-diovascular

> > disease (Korndorfer et al., 2003) and

> > breast cancer (Michels & Ekbom, 2004), supporting

> > the CRL view that semi-starvation can be construed

> > as preventive medicine.

> > By contrast, the most obvious effect of the CRL

> > movement on our own work will be to make it more

> > difficult. The scientific endorsement of semi-starvation

> > will be confusing to many of our patients

> > and exploited by some; certainly, it will muddle our

> > message about the futility of dieting by the normal

> > weight. We do not need to sound the alarm, how-ever,

> > about a looming epidemic of CRL in the gen-eral

> > population. Americans have boosted their

> > intake an estimated 300–500 kcal/day over the last

> > 30 years (Putnam, 1999; United States Department

> > of Agriculture, 2002), despite a barrage of publicity

> > about the relationship between overeating and pre-mature

> > death. Publicity about the linkage between

> > undereating and postponed death is unlikely to

> > send millions charging in the opposite direction. If

> > visions of immortality do inspire some people to

> > trim back caloric excess, it may be good for their

> > health—but it will not be CRL. Presumably, we

> > cannot expect to shatter the lifespan barrier simply

> > by eating 300 fewer calories per day if we are cur-rently

> > eating 300 more than the generation that pre-ceded

> > us.

> > For the few who attempt the real thing, however,

> > ED specialists would forecast less favourable out-comes.

> > Far more will be left with a legacy of binge

> > eating, increased adiposity and unwarranted guilt

> > over the abandonment of extreme CR than will see

> > their 130th birthdays. The rare individual who gets

> > into the swing of semi-starvation will do so by pick-ing

> > up the monotonous rhythms and rituals of

> > restricting AN.All the evidence suggests that radical

> > CR is incompatible with a life—of whatever dura-tion—

> > that is genuinely lived `at liberty' (Vitousek,

> > Gray, & Grubbs, this issue).

> > Yet within these disheartening prospects, the CRL

> > movement affords some extraordinary opportu-nities

> > to our specialty area (Vitousek, Gray, &

> > Talesfore, in press). While few ED experts would

> > endorse the adoption of CRL by people—within or

> > outside the context of research—we would be foolish

> > to ignore an emerging phenomenon that we oppose

> > but cannot control. Because semi-starvation affects

> > so many aspects of functioning, efforts to decode

> > the physiology and psychology of AN have always

> > been hampered by the lack of an appropriate com-parison

> > group. When we detect peculiar neuropep-tide

> > levels or distinctive cognitive styles in

> > individuals with AN, we cannot sort out the signifi-cance

> > of those findings by comparing our patients to

> > normal, psychiatric, or even dieting controls. The

> > only satisfactory match for an otherwise healthy

> > anorexic person with a BMI of 16 is an otherwise

> > healthy non-anorexic person with a BMI of 16. For

> > all the reasons reviewed in this series of articles, the

> > latter virtually never occurs in nature—but does,

> > very rarely, occur through freelance CRL. For the

> > first time since the Minnesota Study (Keys et al.,

> > 1950), we have the opportunity to observe sustained

> > semi-starvation in presumably normal individuals

> > leading more or less ordinary lives in peaceful and

> > prosperous societies.

> > In addition to the research opportunities afforded

> > by CRL, the phenomenon may also help us see a

> > familiar disorder from a fresh perspective. In cases

> > of extreme CRL, we are witnessing the emergence

> > of eerily `anorexic' beliefs and behaviours in indivi-duals

> > (such as middle-aged males) at close-to-zero

> > risk for a conventional ED (Manke & Vitousek,

> > 2002; Vitousek, Gray, & Talesfore, in press). More-over,

> > we can often trace the origin of their stereo-typed

> > symptoms to a specific idea to which they

> > were exposed at an identifiable point in time and

> > resolved to pursue consciously and purposefully.

> > In their view, the costs of chronic CR are justified

> > by its anticipated rewards—and many sane, serious

> > scientists agree. In other words, the identification of

> > a different reason for semi-starvation shifts the popu-lation

> > `at risk' and changes assessments of its ration-ality.

> > Patterns that appear mysterious and

> > pathological in the context of ANcan be seen as sen-sible,

> > even admirable, in the service of goals that

> > observers understand and endorse.

> > Our own view is that both the pursuit of thinness

> > and the pursuit of longevity are insufficient bases for

> > radical restraint; however, if the example of CRL can

> > illuminate the power of personally compelling

> > motives for disordered eating, the ED field will ben-efit

> > from giving it more thoughtful attention.

> > REFERENCES

> > Fairburn, C. G., & Brownell, K. D. (Eds.), (2002). Eating

> > disorders and obesity: A comprehensive handbook. New

> > York: Guilford Press.

> > Fontana, L., Meyer, T. E., Klein, S., & Holloszy, J. O.

> > (2004). Long-term calorie restriction is highly effective

> > in reducing the risk for atherosclerosis in humans.

> > Proceedings of the National Academy of Sciences, 10, 6659–

> > 6663.

> > Garner, D. M. (1997). Psychoeducational principles in

> > treatment. In D. M. Garner, & P. E. Garfinkel (Eds.),

> > Handbook of treatment for eating disorders (2nd ed.) (pp.

> > 145–177). New York: Guilford Press.

> > Keys, A., Brozek, J., Henschel, A., Mickelsen, O., & ,

> > H. L. (1950). The biology of human starvation (2 vols).

> > Minneapolis, MN: University of Minnesota Press.

> > Korndorfer, S. R., Lucas, A. R., Suman, V. J., Crowson,

> > C. S., Krahn, L. E., & Melton, L. J. III (2003). Long-term

> > survival of patients with anorexia nervosa: A popula-tion-

> > based study in Rochester, Minn. Mayo Clinic

> > Proceedings, 78, 278–284.

> > Manke, F. P., & Vitousek, K. M. (2002). Comment:

> > Hunger, semi-starvation, and ill-health. American

> > Psychologist, 57, 371–372.

> > Masoro, E. J. (1988). Food restriction in rodents: An

> > evaluation of its role in the study of aging. Journal of

> > Gerontology: Biological Sciences, 43, B59–B64.

> > Michels, K. B., & Ekbom, A. (2004). Caloric restriction and

> > incidence of breast cancer. JAMA, 291, 1226–1230.

> > Polivy, J. (1996). Psychological consequences of food

> > restriction. Journal of the American Dietetic Association,

> > 96, 589–592.

> > Putnam, J. (1999). U.S. food supply providing more food

> > and calories. Food Review, 22, 2–12.

> > , S. B., Pi-Sunyer, X., Kuller, L., Lane, M. A.,

> > Ellison, P., Prior, J. C., et al. (2001). Physiologic effects

> > of lowering caloric intake in nonhuman primates and

> > nonobese humans. Journals of Gerontology (Series A),

> > 56A, 66–75.

> >

> >

> > Cheers, Alan Pater

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Obviously, the 'average' user needs to move toward lower BMI levels.

And that means losing fat in most cases. The literature is clear on

this, isn't it. However, BMI is very general measure, shows a 'trend'

one way or the other. Mike Tyson has a BMI of 30.4 which is considered

borderline obese. Would you say he is obese? BMI says he is. Is this

enough? Obviously, his individual physical characteristics preclude

him using this as a measure of any kind. But we are all individuals

with individual physical characteristics, so is this is only a rough

measure for any of us. I think that's all it was intended to be.

I agree with mike, we need objective measures of success or results.

Body fat % is start. Serial blood chems are another. Physical exams by

qualified docs another. Just drinking green tea and 'watching' your

cals is too subjective.. :D

>

>

> >

> > Excuse me if that longwinded exposition seems like " toying " with

you. The

> > whole thing was meant honestly, as a set of questions I thought

people could

> > help me out with. You, Francesca, are the list moderator, so your

comment

> > strikes me as quite a rebuke--something I might entirely disregard

from

> > someone else.

> >

> >

> >

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