Writing in The Conversation, Spear describes the exact feeling a lot of us experience in the gauntlet of massive holiday meals that end every year. Specifically, she examines them through the lens of the Japanese word “betsubara,” or “separate stomach.”

The Japanese have not discovered a second cow-like stomach in humans. The term is a silly colloquial way of describing the sudden and seemingly inexplicable desire to find room for dessert when there previously was no room for anything else. The sensation is real, Spear argues, but there’s nothing especially fascinating going on in our stomachs that makes room for sweet treats.

While our stomachs find a way to accommodate any desserts we put in them, our brains play a bigger role than you’d think.

The human stomach isn’t a rigid container that hits max capacity when it fills to the brim. It’s kind of elastic-y. When you eat, it relaxes through a process called gastric accommodation and expands without dramatically increasing pressure. Dessert is usually soft and mushy, low on fiber and protein, so it doesn’t take up a whole lot of space and doesn’t require much mechanical effort to digest. Ice cream is easier to make room for than a second steak, for instance.

Hunger doesn’t shut off once you’re physically full. What takes over is “hedonic hunger,” the urge to eat for pleasure rather than necessity. This is where your brain takes over. Desserts activate the brain’s reward system, releasing dopamine and temporarily quieting signals that tell your stomach you’ve had enough.

You may not need dessert, but your brain wants it — and it will perform all the complicated mental gymnastics necessary to convince you that it’s not just a good idea, but the best idea.

As you eat one type of food, your brain gradually finds it less rewarding. Switching to something sweet or creamy or both refreshes that response. That’s why someone who can’t finish their main course might still be able to find a little room for dessert. Their bellies may not be full, exactly, but they may be experiencing a kind of overstuffed sensory response that needs a little novelty to reset interest.

Fullness signals from hormones like GLP-1 and peptide YY take 20 to 40 minutes to fully kick in. Dessert decisions often happen before that system has caught up. Restaurants know this instinctively, offering menus while our natural reward system can still be exploited. Add cultural aspects, like how dessert is often seen as a celebratory act or part of a ritual, and then toss in a little bit of emotional eating when we need a sugary pick-me-up, and it’s easy to understand why, especially during the holidays, there’s always room for dessert.

The post Humans Have Grown a ‘Second Stomach’ Just for Desserts, Scientist Says appeared first on VICE.

Holding a bottle of ParaGuard liquid drops, glossy influencer Kerry McDonald says, “I know I have parasites, I have all the symptoms,” noting she counts vomiting on a recent trip to Mexico as one of them. “I’m severely bloated all the time, I have IBS, I have all these gut issues.” She claims that five minutes after taking her first dose of 30 drops, she went to the bathroom and excreted something unmistakably worm-like. “I’m too grossed out, I’m like shaking,” McDonald continues, gesturing a foot-long worm with her fingers. “I took a photo but I’m not going to do that to you guys.”

Another post sees influencer Shani Grimmond laugh while exclaiming, “I cannot believe I got 40,000 followers after my parasite cleanse video!” She, too, references a photo she doesn’t end up sharing and tells her viewers she’s “going to make sure we see some parasites one way or another after this journey is done” – before immediately backing out claiming it’d be “too far”. Grimmond reveals (in a whisper) that her parasite paranoia is because she has mucus in her poo. “Most of us have parasites anyway, you just don’t know it,” she giggles, noting plans to up her dose of “natural parasite cleanse papaya seeds”.

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Abdominal pain, bloating, gas, brain fog, teeth grinding, anxiety, constipation, insomnia and acne are all symptoms that influencers promoting parasite cleansing on TikTok are claiming – but couldn’t these be a sign of any number of gut problems? And what actually is a parasite anyway?

According to the Centre for Disease Control and Prevention, a parasite is “an organism that lives on, or in, a host organism and gets its food from, or at, the expense of its host”. But are they as common as TikTok would have us believe?

“With the exception of enterobius, also known as pinworm and threadworm, parasites are very rarely acquired in the UK,” says consultant parasitologist Laura Nabarro. Further research online shows they’re just as hard to get in the U.S, too. “Most people with gut parasites acquire them when travelling to countries with more basic hygiene, often through eating and drinking contaminated food or water.” Though some can be caught by walking barefoot in tropical countries, she adds.

As for parasite cleansers, they’re said to work by killing the parasites inside you with their “unique blend of herbs including wormwood, pumpkin seed, garlic bulb and more” according to the ParaGuard website. Sure, all of these have healthy-sounding antioxidants, but can you really imagine your doctor treating parasites with a supplement you don’t even need a prescription for?

Nabarro calls bullshit on TikTok nutritionists like Joy McCarthy advising people to take parasite cleansers, especially when they say things like they’re more effective on a full moon when the parasites are “more active”. Nabarro says doctors would never prescribe a parasite cleanse for actual parasites.

“Gut parasites can be diagnosed in an accredited laboratory by microscopy and molecular tests on stool samples,” she continues. “Once the type of parasite is identified, these are easily treated with antiparasitic medications which can be prescribed by doctors, including GPs.” Most of the cleansing agents available on the internet, Nabarro says, have not been tested in medical trials for safety or efficacy.

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Scotland-based fishing guide Fred, who’s chosen to remain anonymous for privacy reasons, was officially diagnosed with a (cough… genuine) stomach parasite in 2015, after drinking contaminated water in Mozambique.

“I started shitting blood, was in crippling pain and couldn’t move without being doubled over,” says the 32-year-old. “I was hospitalised for two weeks and it took ages to diagnose the parasites – it was the worst experience I’ve ever had.” Fred was given morphine and antiparasitics through a drip and had the, um, pleasure of cameras being forced up his rear end. “It’s taken me years to recover from,” Fred continues, noting he lost a stone and a half through the process. “Oh, and there wasn’t a worm coming out of my arse during the whole process.”

So where did this worm myth come from? TikToks and Instagram reels from holistic therapists often share “results” from their clients (montaged together over an upbeat song from David Guetta, of course) and almost always show literal worms in the poo. Some look like your average garden worm, some a rat tail and many are even spread out next to a ruler. These look so horrifying that it’s hard not to question their authenticity, but do parasitic worms actually look like this?

“Adult Ascaris worms look very similar to earthworms,” Nabarro explains. “But Ascaris is very rare in the UK and it’s even more unusual to pass the adult worms in the stool.” Earthworms can (very rarely) be found often in toilets, she admits, but only because they live underground and sometimes find their way into pipes and sewer systems. In all fairness, though it’d be a huge coincidence to find one in your toilet during a cleanse, it isn’t completely impossible.

Years of medical experience makes Nabarro believe that the “worms” everyone thinks they’re seeing are actually mucus strands or undigested organic matter. “They look very similar to worms but can be easily distinguished when examined under a microscope,” she says. If you consume harsh enemas – fluids used to cleanse or kickstart the emptying of your bowel – this can “damage the lining of the bowel by increasing rapid passage of undigested organic matter, which can sometimes resemble parasites”.

But the TikTok misinformation cycle continues. Terrifyingly, some creators go as far as claiming parasites are the cause of endometriosis and even herpes.

“It’s all formed by a parasite that gets into your body by way of processed foods and all this nasty meat stuff you eat,” says self-proclaimed holistic spiritual guide Elohim (@iamelohim396) on TikTok. “All the processed foods cause the parasites, all the parasites cause the herpes and you can easily get rid of herpes by starving those parasites.”

This video has a scary 193,400 likes and comments such as “thanks for sharing”, “facts” and “so true” with love heart emojis. Though his account seems to be deleted now, his videos remain widely quoted and re-shared. Similar videos even have hundreds of comments from mothers saying they’ve given parasite cleanses to young children.

This all poses the question whether it’s the companies themselves whipping us into a frenzy by paying influencers to post about their products. Some creators hold their hands up a very faded “paid partnership” icon on their videos, but most don’t – yet they use hashtags that are suspiciously similar and tag the ParaCleanse company Zahler, too.

We reached out to many parasite cleanse TikTok creators, including those mentioned in this piece, and only two were willing to respond. Kerry, mentioned earlier, firmly denies being paid, but also forgot to mention she receives commission from a different parasite cleanse on her Amazon shop. The other influencer confessed to her post being a paid partnership – though, she’s adamant she did pass worms.

With most of the parasite cleansers seemingly sold out on Amazon, it’s a worrying insight into the power social media and influencers have over your health. ParaGuard is not an FDA-approved drug – it gets around this by being categorised as a supplement. It may actually contain everything on the ingredients sheet,  but its health benefits haven’t been approved by scientific testing.

Unless, like Fred, you find yourself drinking regularly from rural wells, picking up a parasite is thankfully very unlikely. The authenticity of the advice being posted online about them is even rarer. If  you do actually have any of the symptoms, turn to your doctor – not influencers on TikTok. After all, it’s much easier to get sucked into an internet wormhole than it is to actually be diagnosed with a real worm… in your hole.

@elizabethmccaff

The post TikTok’s Gut Parasite Cleanse Trend Is Fake, Say Experts appeared first on VICE.

There’s a growing body of research that links the bacteria in your gut to a number of things such as your weight, your mental health, how you react to certain medications, how your genes work, as well as a number of different diseases, such as Crohn’s and ulcerative colitis. And due to this growing popularity of gut microbiome research, a rash of at-home gut bacteria testing kits have popped up on the market all claiming to be able to help you improve or fix your health.

The testing kit I used is called SUPERBIOME from a Toronto-based startup lab called uBioDiscovery, and costs about $255 US, or $329 Canadian, for two samples to be taken as well as a 30-day supply of a probiotic supplement. (I was comped for the purposes of this story). The nondescript box comes in the mail and is equipped with a very basic set of instructions, two sample tubes, two “feces collection devices,” a bottle of probiotics and two pre-paid UPS mailing envelopes.

The particularly graphic act of defecating on a piece of paper that wraps around your toilet seat is step two and four of the gut bacteria testing kit. The first step is to activate your account and fill out the surveys about your background, diet and lifestyle; a.k.a. boring stuff.

After collecting and mailing your first “sample,” you then take probiotics twice a day for the next 30 days. You also have to keep a food diary for the first week, which made me feel like my every food choice was under intense scrutiny and being used as a benchmark for how well I was coping as an adult. (Hint: not well).

Still, I documented my food and and took all of the included probiotics without any major upsets. Then came time for sample number two (pun intended). My second sample was due right after the Christmas holidays where I’d eaten nothing but carbs, cheese, and red meat—not ideal dietary conditions for this kind of experiment. Nonetheless, I mailed off my samples to a next-generation sequencing lab where they would sequence the bacterial DNA in the sample and I waited for my results.

The kit boasts that my results will help me tailor my diet “to promote the growth of beneficial bacteria, and inhibit the colonization of pathogens.” In other words, by getting the DNA in your gut bacteria sequenced you can allegedly “make your microbiome healthier, which will, in turn, make you healthier,” says SUPERBIOME co-founder Aly Burtch.

Burtch and co-founder Alejandro Saettone analyze the results and send you a personalized report of what’s happening in your gut microbiome, as each type of bacteria can play a different role in the body, and they advise you on what you could do to make it better / healthier.

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That being said, when I read the fine print on their website, it noted that the results don’t “constitute medical advice” and are “meant to be used as a guideline.” Also worth mentioning, the kit still doesn’t look at fungi or parasites, both of which could impact your health. (Burtch clarifies that anyone purchasing the product would see a clear disclaimer before they buy explaining that it’s not meant to be used as a diagnostic tool.)

It took until October for my results to come back, almost a year since I took the initial sample. (Burtch says that their turnaround time now is four to six weeks.) The results were kind of confusing at first glance. It was just a list of the various kinds of bacteria broken down into categories. Next to the name is the percentage I had of each and I could compare if it went up or down between sample one and two. I could also click on the names of the bacteria to find out what it was associated with, but it didn’t tell me if my results were in the high or low range.

I went back to Burtch to get the results decoded and she pointed out a couple of things that stood out. For example, my levels of Bacteroidetes were much lower than my Firmicutes. Firmicutes are really good at getting calories from food, so the more you have of them the easier it is to gain weight. This is why, according to Burtch, having high levels of Firmicutes is associated with obesity and high adiposity (fat storage). If you can reduce them by upping your level of Bacteroidetes, then you could theoretically lose weight.

She also told me that I had lots of Faecalibacterium Prausnitzii. “This is one of the most important beneficial bacteria in the human gut microbiome. This bacteria is an immune booster, and ferments dietary fibre producing butyrate and short chain fatty acids, which are important in maintaining gut health,” Burtch says.

The results also gave me recommendations on how to get my gut microbiome back in check. Mine said I should eat more high fiber foods such as fruits and vegetables, and avoid “inflammatory foods” like sugar, milk, processed meat, fast food and alcohol. Unsurprising, since that’s the standard advice given to literally everyone on how to improve their diet and overall health. They also say to start taking specific kinds of probiotics such as Bifidobacteria and Lactobacillus to improve digestion and my immune system, but I’m kinda skeptical since there’s not much evidence they are beneficial for your health.

The results also suggest I switch to a paleo or vegetarian diet, but seems like kind of an extreme way to up my fiber intake.

But honestly, I’m not sure it really matters what my results are. As I came to learn there are a number of shortcomings with these at-home testing kits that make them no better than the Meyer-Briggs test is at telling you how well you’re going to do in a job.

“[The kits] are very much about scientific discovery. It’s going to be biased and it’s not going to be complete,” says Rob Knight, co-founder of the American Gut Project and professor at University of California, San Diego. (The American Gut Project also sells a testing kit.) These tests can probably tell you if you have a serious bacterial infection, he says, but they can’t yet diagnose patients with diseases and are unlikely to reliably provide the kind of personalized information they claim they will.

Knight explains the tests might be able to provide guidelines for a very specific sample population but if you try and generalize those results to a more diverse population you’d need to re-do an entire study. In other words, unless you fit the exact profile of the study they used to analyze your gut bacteria, your results probably won’t be able to tell you much, except for the species of bugs that make up your microbiome.

This can still be a cool thing to know if you’re curious. And some citizen science groups are hoping that with contributions from many people, the mysteries of the interactions and our microbiomes and health will be better understood. Right now, gut microbiome research is still very early days, and many of the studies that these tests base their analyzes off of are done with small sample sizes. Any links found between the gut and disease, weight, mental health etc. are correlational, not causational.

For example, I have high levels of Firmicutes which, as Burtch points out, is linked with obesity. But, for the record, I am nowhere near obese. So just because high levels are seen in obese people more than skinny people doesn’t necessarily mean that the bacteria makes you obese. One does not guarantee the other.

Also, the results only show a snapshot in time of your gut microbiome. While the gut microbiome usually remains relatively stable over time there is evidence that shows it can change rapidly, even meal to meal.

“Say you were eating a cheeseburger and a beer for lunch, you would see a change in your microbiome,” Burtch says. At the time I took my samples I was eating like King Henry VIII. There was a day where I ate cake for breakfast and dinner. And no, it was not just the dessert portion of a larger meal. Cake was the main event. There was also a day where I drank seven different types of alcohol (don’t judge me; my hangover was punishment enough.) With that in mind, my results can’t really be expected to paint an accurate picture of what my gut microbiome is usually like.

In order for me to get anything meaningful I would have to look at my microbiome over time, which is what SUPERBIOME is intended for. But that means I have to take more than two samples—and that’s gonna get kinda pricey. Jack Gilbert, faculty director of the Microbiome Center at the University of Chicago, estimated in a interview that it could cost consumers upwards of $6000 to monitor your gut microbiome over the months (or years) that would be needed to get any meaningful data.

But probably the biggest sign that these kinds of tests shouldn’t be taken too seriously is, as Knight points out, the fact that the FDA hasn’t approved a single one of these kits. (Burtch points out that the kit isn’t meant to be a diagnostic tool, hence why they didn’t seek approval.) So my gut feeling about these tests is that they’re fine to do as an experiment or perhaps learn a little more about what’s swimming around in your body but it’s important to understand the limitations of the results. You don’t need this test to tell you to stop eating like a trash. And if you actually have a gut-related disease go to the doctor and sort your literal shit out.

In response to these reflections, Burtch points out the following: “The SUPERBIOME kit not only provides you with the composition of your microbiome, but also with dietary suggestions based on your unique community of gut bacteria. The diet suggestions are not intended to be a long-term solution; instead the goal of following this diet is to help bring balance back to your microbiome, and an increased diversity. Many of our customers notice that when they eat a healthier and more balanced diet, they experience less bloating, faster digestion and less inflammation. Since SUPERBIOME is a monitoring program, it is a great way to track your microbiome over time, and see if there are certain symptoms that you are experiencing that are related to specific profiles of gut bacteria.”

As for me, this test mostly just gave me some real world practice for when I need to do my colon cancer screening test in 25 odd years and serves as a great reminder that I should probably eat more fruits and vegetables this Christmas season.

11/8/18: This story has been updated to include a followup statement from Aly Burtch.

11/8/18: This story has been corrected to reflect the fact that paying customers get a pre-purchase disclaimer that the product is not to be used as a diagnostic tool, and updated to reflect the fact that the American Gut Project also has a microbiome testing kit. We regret the oversights.

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The post I Took an At-Home Poop Test appeared first on VICE.

Forget everything you thought you knew about slicing fruit open on your abdomen. Let me introduce you to the one, the only, the real-life Fruit Ninja himself, Ashrita Furman.

Just watch this master work:

Furman manages to ravage 26 melons in one minute without slicing himself, aided by a team of faithful lackeys working in unison to clean up the halves and set up a fresh melon on his belly chopping block. Once he successfully sets the record, Furman rises and surveys his stomach which, while hairy and matted with the juicy carnage of his melon rampage, somehow didn’t get cut. Incredible.

As skilled as Furman may be slicing melon with a samurai sword, chopping fruit isn’t his only calling. The guy is basically a professional world record breaker. According to his website, Furman says he’s set more than 700 records in his lifetime, and currently holds more than 200—including fastest somersaulting, largest popcorn sculpture, longest underwater pogo stick jumping, and, yes, most watermelons chopped on your stomach in 60 seconds. He also holds the world record for most world records, because of course. Truly a hero.

Thank you, Furman, for pushing the boundaries of human potential forward once again. May your great success teach our children and our children’s children that they, too, can slice as many delicious summer fruits on their bodies as their hearts desire—all we have to do is set our minds to it. And grunt with each chop, apparently.

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The post Please Watch This Real-Life Fruit Ninja Slice Watermelons on His Belly appeared first on VICE.

The feces—or stools—we produce can provide a valuable real-time window into the health of your large bowel (or colon) and gastrointestinal tract. So let’s put those rules aside.

Scientists research many odd topics, and stool form is no exception. In 1998, Stephen Lewis and Ken Heaten from the University of Bristol developed a seven-point stool form scale, ranging from constipation (type 1) to diarrhea (type 7).

Today, the Bristol Stool Chart allows people with gastrointestinal symptoms to clearly describe to their doctor what they are seeing in the toilet without having to provide samples.

The Conversation, CC BY-ND

For most of us, the form of stool we excrete can vary widely depending, in part, on what we’ve been doing. A period of dehydration, perhaps associated with a day of sustained exercise, or the delaying of a bowel movement, may be followed by a drier stool form than normal.

Conversely, an unusually spicy meal might be followed by a bowel movement with a looser stool.

How should your stools look?

Ideally, stools should be easy to pass without straining and without any intense sense of urgency.

On the Bristol Stool Chart, these are types 3, 4 and 5: sausage-like with some cracks in the surface, up to 2 to 3 cm in diameter; longer sausage or snake-like with a smooth consistency, similar to that of toothpaste with a typical diameter of 1 to 2 cm; or soft blobs with clear cut edges.

While arguably easier to clean up, the drier stool forms (types 1 and 2) tend to compact into large stool that can apply long term pressure to and abrade the lining of the large bowel. During a bowel movement, dry stools may distend the anal canal beyond its normal aperture. This may require straining—and pain—to pass.

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Straining to pass dry stools increases the risk of laceration of the anus, hemorrhoids, prolapse, and the condition diverticulosis. This is when pouches form on the wall of the large bowel due to over-distension. These can become sites for infection or inflammation.

Watery stool forms may be associated with gut infections, for example with a gut parasite like Giardia, or an inflammatory disorder such as Crohn’s disease. As a rule, softer but not watery stool forms are best. Any change of bowel habit that leads to the sustained production of drier stools and a sense of incomplete emptying—or watery stools and a feeling of urgency—should be discussed with your doctor.

Why does water matter to stool?

Even to the casual toilet bowl observers among us, the most obvious differentiating factor between stool forms is their water content.

The large bowel is an amazing recycling and repurposing centre for the body. Water recycling is one of its key functions. Every day, our bodies invest around 9 liters of fluids into the digestion of food, including around 1.5 liters of saliva, 2.5 liters of stomach secretions and 0.8 liters of bile. But clearly we don’t defecate anywhere near this volume.

The longer it takes for digested food to pass through the large bowel, the more water gets reclaimed and the drier the stool becomes. So factors affecting the transit rate of food through our gastrointestinal tract will have significant influence on stool form.

Affluence and lifestyle impact on transit time. Antibiotics, pain killers (particularly opiate-containing drugs such as Endone but also more common pain-killers containing codeine) as well as physical inactivity all reduce how well the gut contracts. This slows the passage of food through the large bowel, which can lead to constipation.

What about diet and stool?

Our diets also play a significant part in driving stool form and health.

Observational studies performed in south and eastern Africa in the 1970s and ’80s compared the gastrointestinal health of Caucasians eating a Western-style diet and native Africans living a traditional lifestyle. The researchers found drier stool forms and constipation were more common in people consuming Western-style diets.

This was associated with increased incidence of bowel cancer, inflammatory bowel diseases as well as other chronic diseases of rising incidence in Western societies. The results were attributed to differing levels of fiber in the diets of these two populations and these conclusions have been clearly confirmed for bowel cancer in numerous studies.

Fiber impacts on transit time, stool form, and health in two ways. First, when a healthy, well-hydrated person eats fibrous foods such as wheat bran with lots of roughage, the food takes up water and swells. This increases the volume of the stool, softening it, stimulating more rapid transit. At the same time, it dilutes and more rapidly clears any toxins that may have been ingested with the food.

More potent components of dietary fiber also exist: fermentable carbohydrates such resistant starch (a form of starch that is not digested in the small intestine), beta glucans and fructo-oligosaccharides, which are commonly found in whole grains, legumes, pulses, fruit and vegetables. These are a key nutritional source for the trillions of bacteria that inhabit the large bowel (the gut microbiota).

Key waste products of this bacterial feast, short-chain fatty acids, are like gold to our bodies. One of these short-chain fatty acids, butyrate (which is also the food acid that gives parmesan cheese its haunting aroma), reduces transit time by strengthening contraction of muscles lining the large bowel.

On the way, these short-chain fatty acids strengthen, grow, and repair the cell layers that line the large bowel. They destroy cancerous cells, reduce inflammation and pain in the gut, and enhance satiety. Worth feeding, you might say.

But one gastronomic casualty of the Westernization of our diets has been fiber. A typical Westerner may consume as little as 12-15 grams of fiber per day. While no upper limit for daily fiber intake has been defined, healthy Australians are recommended to consume at least 30 grams of dietary fiber per day, with around 15-20 grams of that comprising resistant starch.

So clearly we have some distance to go. There is a caveat here, however. If you have gastrointestinal symptoms—such as an upset stomach, nausea, vomiting, and diarrhea—fiber may not always help. You may need to carefully consider the type of fiber you consume with the help of your doctor.

The roughage component of some fibre sources may exacerbate symptoms for people with diverticular disease, for instance. Symptoms of irritable bowel syndrome may be exacerbated by fiber sources rich in fermentable fructose oligo, di or mono saccharides and polyols (FODMAP). This includes onion, garlic, apples, pears, milk, legumes, some breads and pasta, and cashews.

For most of us, though, more fiber in our diets should reduce food transit times, soften stools, make bowel movements more comfortable, and improve bowel health.

Trevor Lockett is the group leader for personalized health at the Commonwealth Scientific and Industrial Research Organization (CSIRO) in Australia. This article was originally published on The Conversation. Read the original article.

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The post What Your Poop Looks Like Can Reveal a Lot About Your Health appeared first on VICE.

During that latter half of that crazy 28-day period, I ate consistently less than I ever have in my life, about 1600-1800 calories per day. The 1600-1800 calories per day wasn’t a range prescribed by my trainer, Ngo Okafor. Calorie counting is emphatically not his bag. It just happens to be the amount of energy contained in three square meals that brimmed with leafy green vegetables, lean meats, fish, and eggs on any given day. Here’s why that figure is so shocking to me: Last year I took an indirect calorimetry test that determined that my body needs 1507 calories of food energy per day to merely exist without losing weight.

The process of breaking down food for energy also consumes energy. Dig this: If I ate 1507 calories and laid in bed all day, I’d need roughly 150 extra calories to exist at the same weight. (The digestion of the food we eat requires around 10 percent of the energy contained in that food to break it down in process known as thermogenesis.) All this to say that 1,657 calories per day is what I’d need to maintain my weight if I finally got around to binge-watching ‘The Wire’ and literally shat where I ate.

But as I said, in the process of getting me some abs, I was decidedly not doing nothing all day. I walked two miles each way to the gym, ran a sub-8 minute mile on the treadmill when I got there, did a fast paced hour of resistance training then did an hour on the elliptical while re-bingeing Game of Thrones. Additionally, I was walking between three and five miles per day just running my usual errands.

The thing is, aside from one day during which I worked out too much and ate far too little and almost fainted (I didn’t make that mistake again), I never once felt hungry or heard my tummy rumble. At some point, wasn’t my body supposed to tell me to start ransacking the fridge or firing up Seamless via hunger pangs?

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This lead me to wonder why I’ve felt far hungrier on days in which I’ve eaten twice the amount of calories and performed very little exercise. Is it the increased amount of protein that’s keeping me sated? The gallons of water I’m drinking? The shrinking of my stomach? I needed answers.

“Your stomach probably didn’t shrink,” says Kimberly Eden Steele, director of the Johns Hopkins Adolescent Bariatric Surgery Program, who knows a thing about shrinking stomachs. Steele explains that while the stomach is stretchy—the average human stomach can hold between one and one and half liters of food—contrary to popular belief, it doesn’t significantly shrink beyond its original size when empty.

The bariatric procedure Steele most often performs—sleeve gastrectomy—reduces the stomach to about the size of a banana. Not only does a smaller stomach hold less food before a patient gets full, it also secretes fewer hunger-signaling hormones to the brain; an effect I’ve apparently managed to take advantage of without going under the knife.

“While eating fewer calories didn’t literally shrink your stomach, reducing your carbs and eating lean protein and fibrous vegetables changed the production of hormones that signal satiety,” she says, offering an explanation for this commonly held notion.

Steele tells me that one of the things she’s looking at in her research is how overeating may be dulling the receptors of dopamine. She hypothesizes that perpetual overeating causes people to eat more to get their hit of this feel-good hormone. “If you can break the vicious cycle of overeating more and more to feel good, you’re going to be satisfied sooner and by foods other than the refined carbs that give you quick energy,” she says.

Steele did confirm that the increased amount of water I’m drinking—well in excess of a gallon most days—is playing a big role in staving off hunger pangs. “When you stretch the stomach by filling it, the organ sends messages to the brain saying that ‘you’re full and you don’t you don’t need to eat any more,’” she says, adding that drinking plenty of water is a tried-and-true method of getting the “shut your pie hole” message up the chain of command.

It’s worth mentioning at this juncture that traditionally, hunger hasn’t been the only thing curing me to put food in my mouth. I’m very prone to cravings for sweets even when I’m totally full. Since I’ve started eating well, however, those cravings have largely dissipated.

New York-based Registered dietitian and nutritionist Stephanie Di Figlia-Peck tells me that filling my plate with lots of vegetables and lean proteins is playing a big role in my cravings for sweets. “Feeling a craving for something sweet is physiological,” she says. I’d always just chalked my sweet tooth up to a simple weakness of character.

She goes on to explain that the primary food source for our brain and central nervous system is glucose and if we’re not getting it because we work through lunch or don’t get around to eating dinner until 10 PM, the brain will send very strong signals to compel you to feed it. “The first thing you’re going to crave is sugar because it’s the preferred fuel source of the brain and central nervous system,” she says.

When I ask her about the idea that, if I’m not eating enough, my body goes into starvation mode and begins to hold on to fat stores like grim death, Di Figlia-Peck explains that while this can happen, it would only be something worth considering if my body mass index (BMI) dropped below the “healthy” or “normal” range of 18.5 to 24.9. I currently have a BMI of 21.3. I’d have to lose a further 20 pounds for my metabolism to hit the panic button.

Interestingly, she wasn’t 100 percent on board with my strategy of purging “bad” foods from my apartment. A healthy food environment isn’t one where non-whole foods are gone completely, but one where bad choices aren’t staring you in the face all the time, she says. This idea has been borne out in several studies including one published in the February 2018 issue of the journal Appetite which asserts that “placing food further away reduces the likelihood of consumption in general population samples.”

Di Figlia-Peck ends our conversation by remarking that my enjoying going to the gym every day is creating a virtuous cycle and setting me up for nutritional success. That stands to reason: If I loathed the long batteries of bicycle crunches and hour-long elliptical machine sessions, coming home to a lunch consisting of a 4-ounce salmon fillet and steamed broccoli would feel like kick in the balls.

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The post Working Out a Lot Doesn’t Always Increase Your Appetite appeared first on VICE.

We tend to call it heartburn or acid reflux, but what we most often mean is Gastroesophaegeal Reflux Disease (GERD), in which the contents of the stomach escape up into the esophagus. GERD is one of the most common chronic ailments in the US; an estimated 20 to 60 percent of Americans have it at some point in any given year, and many don’t even know it.

Left untreated, chronic GERD can cause everything from chronic cough and shortness of breath to chronic fatigue, insomnia, and sinus infections, according to the Mayo Clinic and the
Cleveland Clinic. It can be hard to pin down because it often masquerades as something else or has no obvious or consistent symptoms. Continuous exposure to acid can also change the cell lining of the esophagus, a condition called Barrett’s Esophagus, and those cellular changes can lead to cancer. It’s a low risk of progression—less than 1 percent per year—but it happens.

If you go to your doctor complaining of any of these symptoms, including the more vague ones, like coughs or throat clearing, you’ll probably be written a prescription for proton pump inhibitors (PPIs). These meds decrease acid levels by dramatically reducing acid production through glands in the lining of your stomach. They are widely available both over-the-counter and by doctor’s prescription under the generic name omeprazole; they’re considered the de facto treatment for chronic GERD. An estimated 15 million Americans in 2013 were prescribed PPIs such as Prilosec, Nexium, Prevacid, and Zegerid, and that doesn’t include the much larger number of people buying over-the-counter versions.

Yet for all the $9.5 billion worth of PPIs prescribed in physicians’ offices and sold in drugstores each year, doctors aren’t completely sure if pH levels in the stomach are the primary cause of GERD, even though that’s what they’re overwhelmingly treating. There could be other, more mechanical, factors at play, like weakness in the sphincter, which closes off the stomach from the esophagus, delayed gastric emptying, or hiatal hernia, says Nipaporn Pichetshote, a gastroenterologist at Cedars-Sinai Medical Center in Los Angeles. For people who have laryngopharyngeal reflux (LPR), which is reflux that only presents symptoms in the throat like throat clearing and globus, it’s even less clear what causes it, how to diagnose it, or if PPIs are effective at all in treating it.

Despite all this, they’re still turned to as the first line of defense, and researchers are finding that there might be consequences to taking these drugs long-term. Last year the British Medical Journal published a large-sample study that found long-term use of PPIs was correlated with a 25 percent higher chance of death. “This was really eye-opening,” says Ziyad Al-Aly, a kidney specialist at the Veterans Affairs St. Louis Health Care System and the study’s lead investigator. “We knew PPIs [were] associated with a number of adverse effects, but there really was no [prior] big study showing a relationship between PPI use and risk of death.”

Their findings build on several other recent studies that found previously unknown correlations of PPIs and chronic and acute conditions. Together, the studies associated PPI use with a 44 percent heightened risk of developing dementia, 44 percent heightened risk for osteoporotic bone fractures, 20 percent heightened risk for heart attack, 70 percent heightened risk for clostridium difficile infections (which can be life-threatening), 30 to 50 percent heightened risk for chronic kidney disease, and an increased risk of stomach cancer.

PPIs can also cause problems with vitamin and nutrient absorption, like B12, or can lead to a magnesium imbalance and worsen existing kidney disease compared to study patients who took H2 blockers. H2 blocker are another, potentially safer, medication to reduce stomach acid, but they lose their effectiveness with long-term use, and don’t appear to work as well or as quickly, according to Pichetshote. (Tonic reached out to Proctor & Gamble, maker of Prilosec, and AstraZeneca, maker of Nexium, but neither chose to comment on the findings or our story.)

More from Tonic:

To top it all off, it can also be extremely difficult to quit a PPI once you start one because of an intense withdrawal period. When the proton pumps in your stomach start to produce acid again, you will experience what’s called an acid rebound. Your stomach will make a higher-than-normal amount of acid before eventually tapering off to regular levels. Studies have shown that PPIs can cause reflux symptoms in people who didn’t have them before, when they tried to quit them. This can heighten GERD symptoms and lead people to reach for their meds again, leading to long-term use.

For now, the BMJ study authors caution that their findings shouldn’t deter the prescription of PPIs entirely, only that doctors should weigh the benefits of suppressing GERD against the increased risk for other conditions, which vary from patient to patient.“[But] when we evaluate PPI use, the story is consistent,” Al-Aly says. “PPIs are over-prescribed and also used for a longer duration of time than is necessary.” The study’s authors stress that the evidence is new and not conclusive, but it suggests PPIs may alter normal cellular processes and erode the ends of chromosomes, both of which interfere with the body’s regular maintenance of itself, leaving it vulnerable to soft tissue damage.

The BMJ study’s sample was large—6 million people—but the patient group was pretty homogenous: They were mostly older white military veterans. It remains to be seen how PPIs are correlated to the health of younger people, women, and people of different races.

The study probably won’t lead to the discontinuation of PPIS, but encourage doctors to move patients off indefinite use of PPIs and toward episodic use instead. In the near future, a patient may be more likely to be prescribed a PPI for two to four weeks and then taken off it, says Pichetshote. The days of a doctor prescribing a lifetime of PPI use could be coming to an end.

If you want to manage GERD without PPIs or H2 blockers, you might try changing your diet or lifestyle. Small studies have found that people who adhere to low acid diets report less symptoms, or that plant-based Mediterranean diets can be as effective as medication, especially for LPR. It’s a drag to give up your morning coffee and orange juice, but if your symptoms are severe and you don’t want to take a PPI, those–along with tomatoes and spicy foods–are the main offenders to put on the do-not-eat list. Other simple changes you can make are eating smaller meals, avoiding eating a few hours before bedtime, and lifting the head of your bed, so you sleep on an incline.

There are also more controversial home remedies and over-the-counter herbal medications. One untested remedy going around the internet lately is a daily dose of apple cider vinegar. “If it provides relief, I don’t think it’s harmful,” Pichetshote says. “However, there is acid in apple cider vinegar, so it’s promoting the cycle of reflux.” Others find relief in bubbly mineral water, such as Perrier, though many doctors say carbonated beverages exacerbate reflux. Pichetshote cautions that it doesn’t prevent reflux or heal anything, and that even carbonated mineral water is acidic. You can also try TUMS, Maalox, or Alka-Seltzer Gold, which is a hard-to-find aspirin-free version. They all work quickly, according to Pichetshote, but they also stop working quickly— within 30-60 minutes—and several have high doses of calcium, of which repeated doses can cause constipation.

Lifestyle changes are your best bet for reducing GERD. Quit smoking, exercise, drink less alcohol, and avoid spicier and fattier foods. If you’re already doing these things and still have chronic GERD, though, your options for the foreseeable future are to tough it out with PPIs or H2 blockers in short-duration treatments.

Read This Next: Is Your Insane Hot Sauce Habit Destroying Your Stomach?

The post The Dangers of Taking PPIs for Acid Reflux appeared first on VICE.

Ah, friends. They’re like family but cooler. Fully customizable. Fall and one of them will be right there to pick you back up. But as great as friends can be, they also do a lot of really stupid stuff. Stuff that blows your mind. Like, sometimes it seems crazy that you even hang out with people who make such crappy decisions. Stuff that, were it to get out, would be mortifying for anyone with even a shred of self-respect. Lucky for your friends, they’ve got you to ask their deepest, darkest questions for them. And lucky for you, we started this column to answer those most embarrassing of queries.

The Scenario
Your friend is really into hot sauce. No like, really. She’s carried it in her bag way before Bey made it swag. She puts in on eggs in the morning, drowns burgers in it at lunch, and you swear you’ve seen homie take a swig directly from the bottle more than once. Whether it’s Sriracha, your mom’s sambal, Frank’s Red Hot, or even the the basic bitch of hot sauce: Tabasco, the extent to which your friend indulges scares you a little bit. Something has to be happening to her stomach lining or at the very least, her butthole. But peppers can also be good for you. So is the spiciness keeping her alive longer, or should she prep for a fiery gastric explosion of sorts?

The Facts
At the risk of sounding stupid, hot sauce is, well, hot. It makes you cry, it burns your mouth, and heaven forbid you touch a chili pepper and then your eye. So we get it. Logic would follow that if something can cause you physical discomfort, it probably isn’t doing your internal organs any favors. But it’s true that spicy foods can benefit your health.

“Chilies tend to contain large amounts of vitamin A and C. These vitamins may have a slight effect at improving your immune system and helping your body fight infection,” says Hardeep Singh, a gastroenterologist at St. Joseph Hospital in California.

Singh says cultures that eat lots of spicy foods high have lower rates of heart attack and stroke (though he also admits that this could be a result of genetics rather than hot sauce love). The active ingredient in most hot sauce is something called capsaicin, a chemical compound found in chili peppers that messes with the nerve endings on your skin. “Capsaicin is said to lower levels of bad cholesterol in the body, and although the evidence is weak, some suggests that capsaicin helps increase metabolism and promote weight loss,” Singh says.

The Worst That Could Happen
We know what you’re thinking: Why can some people take hot sauce to the head, but I get volcanic diarrhea just from looking at spicy salsa? Tolerance for spice varies widely between people, but that doesn’t mean there aren’t real side effects when someone eats too much.

“The spiciness of peppers is measured in a unit called SHU,” Singh says. “Anything over 1 million shu is very spicy. Some people, when eating these specialty peppers, can experience severe indigestion, nausea, vomiting, abdominal pain, diarrhea, and perhaps even pass out from the effects.” And while it’s debatable whether spicy food actually causes acid reflux and heartburn—they will exacerbate these conditions.

There’s research that shows the long-term effects of spicy food on the cultures that consume high amounts of spicy foods—they might have a higher risk for stomach and throat cancer. And let’s not forget the case where a toddler who was given a ghost pepper suffered from seizure and then died. While we can assume your friend isn’t a baby, it’s pretty damn scary to know that a pepper could be toxic to a (mini) human.

What Will Probably Happen
Your friend is probably going to live, but there’s research that says spicy food can affect taste buds negatively. And that sauce-induced acid reflux and heartburn that we discussed—they can cause stomach pain, tooth decay, and sore throat, so hitting the bottle may not be the best habit but it’s not going to end in a full gastric meltdown. Getting lost in the sauce will probably just give your friend some stomach discomfort and a mounting aversion to any food that’s Mexican, Thai, or Indian.

What Should I Tell My Friend?
If your friend is happy and healthy, let her douse whatever, whenever she wants. But if you’re hell bent on being a buzzkilling sauce-blocker, urge her to pay attention to how she’s feeling. If there is physical discomfort or she finds herself spending too much time on the toilet, it’s a good idea to suggest exercising some moderation.

Leslie Korn, a traumatologist who works with clients to determine how dietary choices impact mental health, also suggests exploring the psychological aspect of their hot sauce habit. “Do they smoke or do they over salt their food, and [as a result] not have a refined sense of taste?” she asks. “Or perhaps is there vinegar or sugar in the hot sauce that they crave and feel energized? Whenever I examine a lot of certain type of consumption I ask: What are you getting out of it?”

The post Is Your Insane Chili Sauce Habit Destroying Your Stomach? appeared first on VICE.

The Scenario
Your friend is really into hot sauce. No like, really. She’s carried it in her bag way before Bey made it swag. She puts in on eggs in the morning, drowns burgers in it at lunch, and you swear you’ve seen homie take a swig directly from the bottle more than once. Whether it’s Sriracha, Frank’s Red Hot, Brazilian hot sauce she bought on the side of the road in Bahia, or even the the basic bitch of hot sauce: Tabasco, the extent to which your friend indulges scares you a little bit. Something has to be happening to her stomach lining or at the very least, her butthole. But peppers can also be good for you. So is the spiciness keeping her alive longer, or should she prep for a fiery gastric explosion of sorts?

The Facts
At the risk of sounding stupid, hot sauce is, well, hot. It makes you cry, it burns your mouth, and heaven forbid you touch a chili pepper and then your eye. So we get it. Logic would follow that if something can cause you physical discomfort, it probably isn’t doing your internal organs any favors. But it’s true that spicy foods can benefit your health.

“Chilies tend to contain large amounts of vitamin A and C. These vitamins may have a slight effect at improving your immune system and helping your body fight infection,” says Hardeep Singh, a gastroenterologist at St. Joseph Hospital in California.

Singh says cultures that eat lots of spicy foods high have lower rates of heart attack and stroke (though he also admits that this could be a result of genetics rather than hot sauce love). The active ingredient in most hot sauce is something called capsaicin, a chemical compound found in chili peppers that messes with the nerve endings on your skin. “Capsaicin is said to lower levels of bad cholesterol in the body, and although the evidence is weak, some suggests that capsaicin helps increase metabolism and promote weight loss,” Singh says.

More From Tonic:

The Worst That Could Happen
We know what you’re thinking: Why can some people take hot sauce to the head, but I get volcanic diarrhea just from looking at spicy salsa? Tolerance for spice varies widely between people, but that doesn’t mean there aren’t real side effects when someone eats too much.

“The spiciness of peppers is measured in a unit called SHU,” Singh says. “Anything over 1 million shu is very spicy. Some people, when eating these specialty peppers, can experience severe indigestion, nausea, vomiting, abdominal pain, diarrhea, and perhaps even pass out from the effects.” And while it’s debatable whether spicy food actually causes acid reflux and heartburn—they will exacerbate these conditions.

There’s research that shows the long-term effects of spicy food on the cultures that consume high amounts of spicy foods—they might have a higher risk for stomach and throat cancer. And let’s not forget the case where a toddler who was given a ghost pepper suffered from seizure and then died. While we can assume your friend isn’t a baby, it’s pretty damn scary to know that a pepper could be toxic to a (mini) human.

What Will Probably Happen
Your friend is probably going to live, but there’s research that says spicy food can affect taste buds negatively. And that sauce-induced acid reflux and heartburn that we discussed—they can cause stomach pain, tooth decay, and sore throat, so hitting the bottle may not be the best habit but it’s not going to end in a full gastric meltdown. Getting lost in the sauce will probably just give your friend some stomach discomfort and a mounting aversion to any food that’s Mexican, Thai, or Indian.

What Should I Tell My Friend?
If your friend is happy and healthy, let her douse whatever, whenever she wants. But if you’re hell bent on being a buzzkilling sauce-blocker, urge her to pay attention to how she’s feeling. If there is physical discomfort or she finds herself spending too much time on the toilet, it’s a good idea to suggest exercising some moderation.

Leslie Korn, a traumatologist who works with clients to determine how dietary choices impact mental health, also suggests exploring the psychological aspect of their hot sauce habit. “Do they smoke or do they over salt their food, and [as a result] not have a refined sense of taste?” she asks. “Or perhaps is there vinegar or sugar in the hot sauce that they crave and feel energized? Whenever I examine a lot of certain type of consumption I ask: What are you getting out of it?”

Read This Next: Weed and Hot Peppers Show Potential for Soothing Your Gut

The post Is Your Insane Hot Sauce Habit Destroying Your Stomach? appeared first on VICE.

The Facts
Before we get to a hard yes or no, here’s a mini-lecture on the mysterious workings of the digestive system “from gum to bum,” according to Lisa Ghanjhu, an associate professor of gastroenterology and hepatology at NYU Langone Medical Center. The more work you do with your teeth and stomach, she says, the less work needs to be done the further down as your food gets into the large and small intestines where the actual absorption of nutrients takes place.

The moment your friend crams a piece of steak the size of a baby’s fist into their gullet, the mouth starts to secrete saliva that’s chock full of enzymes like amylase that help you break down the food right there in the mouth as your teeth get to chomping it. It then travels down your esophagus, whose only purpose is to transfer food from mouth to stomach safely.

In the stomach, a whirlwind of stomach acids, more enzymes, and hormones like ghrelin and leptin (which tell your brain when you’re hungry or full) join the party. However these hormones don’t immediately reach your brain—it can take roughly 20 minutes for that ghrelin “full” signal to sink in, at which point you may have eaten twice as much as your body needs. If you’ve got massive chunks of barely chewed food sloshing into your tummy, it’s going to take a lot more time and effort to break down your food, which can mean bloating, gas, and discomfort.

“The food stays in your stomach until it’s ready to be passed off safely into your small bowel,” Ghanjhu says. And if you pounded a burger and fries, it’s going to take more work to break that down than, say, a vegetable stir fry. And even once it’s broken down it doesn’t all wash into your guts in a big tsunami of food particles. There’s a tiny sphincter at the end of the stomach (before the small intestine) called the piloris—the hallowed gate through which your digested food moves along its merry way to becoming poop, the intestines and colon extracting nutrients as it goes.

“The piloris is the size of a quarter,” Ghanjhu says. So no matter if you ate fifty dollars worth of food, it’s only going to pass out of your stomach in tiny bits. Eating a meal too fast means all that food is going to be sitting in your stomach uncomfortably, since it takes several hours for a meal to be fully digested.

The Worst That Could Happen
It doesn’t matter if that steak tastes like heaven—no meal is worth the risk of taking you those pearly gates. “The esophagus and the trachea are literally adjacent to each other by a thin membrane. If you eat too fast or talk and eat, you can inhale your food and choke,” Ghanjhu says. Not only that, but food that’s not well chewed can trigger an esophageal spasm and the food can get stuck in your throat, she cautions.

Better to practice a little mindful eating, she says, where you slow down, taste every bite, hold the food in your mouth and chew each bite numerous times. “It makes you really taste your food.” If you “eat with your eyes,” as she puts it, “your food hits a volume that triggers a hormone that says stop eating.” If you miss that signal too and keep on eating your stomach gets stretched beyond capacity, and you miss out on the chance to actually enjoy your food.

What Will Probably Happen
If you eat too fast, too frequently, Ghanjhu says, “You can get reflux and venting up of material from the stomach. It’s basic physics.” Acid reflux can cause a burning sensation in the throat (that some people often mistake for a heart attack). It can also manifest as a feeling of being unable to swallow properly, or feel as though there are air bubbles or pressure in your throat. Acid reflux can also show up as burping, nausea, and general gassiness. Especially sexy if your friend is doing his usual food-shoveling on a date. He might even taste bile—a sweet second chance to chew food he already ate.

While eating for pleasure is a perfectly acceptable reason to devour your food, there’s the more important issue of getting the nutrients you need. “The more work you do with your teeth and stomach, the less work needs to be done in the small bowel, and the better your absorption,” Ghanjhu says.

The post How Bad Is it to Eat Really Fast? appeared first on VICE.