The kids are interested in different varieties of tomatoes and ask questions about whether they're heat resistant or not--an essential characteristic during hot Chicago summers. She said, I'm loving the fact that the kids are thinking about their food in a different way. But also learning to love what they grow. These experiences are backed by data. An academic review looking at fourteen different studies found that in ten of the studies, students had notable increases in the number of fruits and vegetables they ate after participating in a gardening program. Although many studies had significant limitations, the review's authors said the results suggest that gardening has a positive influence on children's consumption of fruits and vegetables. Like a toddler with a sippy cup. Every time my tongue tasted those flavors or that sweetness, my brain got the message that I needed a burst of insulin to manage the calories that were on the way . Unfortunately, our brains don't know the difference between regular sweeteners (like honey or sugar) and zero-calorie/artificial sweeteners (such as stevia, aspartame, or sucralose) or flavors from actual food (such as strawberries or chocolate) and zero-calorie-added flavors (including both natural and artificial food-like flavors). Do you remember the saying, You can't fool Mother Nature? Well, these artificial sweeteners and added flavors actually are fooling Mother Nature, and it has definite consequences for our bodies. Our brains don't understand that we have figured out how to make something that tastes like food but actually isn't food, so they prepare for the calories . How does this work? Our taste buds send signals to our brains to prepare our bodies to process the food that is incoming. As an example, sweet, sour, and umami foods increase saliva secretion (which helps our bodies prepare for digestion and food absorption) while bitter flavors (such as black coffee and plain tea) do not have this effect. Besides increasing saliva production, the body also releases insulin as soon as sweetness is detected so that the required amount of insulin will be available as soon as the body needs it. I'm going to lose my job because of this anxiety whenever I have to speak in a meeting. The more you avoid and battle your particular anxiety-inducing event, the more you solidify the lesson neurologically. In other words, you strengthen the neural pathway that connects your feared event to a question of your survival. Now, whenever you approach your fearful stimuli, your brain floods your system with adrenaline and you associate this with fear.

You then indulge in your accompanying fear-based thoughts. And you become anxious again! It goes around and around, like a vicious feedback loop. One experience impacts the other. You become anxious and you fight or run from anxiety. This creates more anxiety as you dodge and resist, again and again. This can be especially true for off-label uses of very expensive medications, such as cancer chemotherapies. In many states there are generic substitution laws. These allow pharmacists to substitute generic drugs for a brand-name drug if a generic exists, is bioequivalent, and of the same dosage if the physician has not marked that the brand-name drug must be dispensed. The main justification of these laws is to save patients money for therapeutically equivalent drugs. Finally, certain drugs--especially cancer chemotherapies, injectable anti-inflammatory drugs, and others--are not sold through pharmacies. Instead, physicians purchase them, administer them in the clinic or office, and are paid by insurance companies. This is called the buy-and-bill system. Since 2003, Medicare has paid based on the average wholesale price of the drug plus 6% for an administrative fee. This payment formula incentivizes the use of more expensive drugs when there are clinically equivalent options because the 6% fee is higher on expensive drugs. Research indicates that physicians respond to this incentive and use more expensive drugs to generate higher payments. In the other group, we removed the same amount of surface (subcutaneous) fat as we'd removed in the form of visceral fat from the other group. In the young group and the older group that had been calorically restricted, we made an incision in their abdominal walls but sutured the wounds without removing fat for the sake of control (known as a sham operation). We measured all the rats' insulin levels and insulin's action regarding driving glucose out of the bloodstream and into the muscle. One of the hallmarks of the metabolic decline that comes with aging is a decline in sensitivity to the effects of insulin, the hormone we need to store sugar molecules.

Insulin is manufactured in the beta cells of the pancreas, and its levels become elevated to overcome the decline in insulin sensitivity. Those of us who can't secrete enough insulin become type 2 diabetics. Obesity accelerates this process because it increases resistance to insulin, so obese people can become diabetic at earlier ages. The gold standard for determining whole-body insulin sensitivity is the insulin clamp test, which my Einstein mentor and colleague Luciano Rosetti and I were the first researchers to apply to rodents and to aging. I had performed insulin clamp studies in humans during medical school at the Technion in Israel, where I worked with my first mentor, Eddy Karnieli, and during fellowships at Yale with leading diabetes researcher Ralph DeFronzo. For the studies, insulin is administered, but glucose concentration is clamped so that the study participants' normal blood sugar levels are maintained--they do not go up or down. Even in studies that didn't result in behavioral change, students who gardened said they were more interested in eating vegetables after the program than before. As Mshar said about her own children, It's exciting to see broccoli on your plate when you planted the seed and watched it grow and watered it and had to put on manure and worms and compost and everything else around it. It really opens up their whole world. Even when kids aren't a fan of a specific vegetable, growing and preparing them gives children more of a sense of control over their diet. It helps them figure out what they actually like or not. At the Youth Garden's school programs, they offer students the chance to try sauces with different flavor profiles: salty, sweet, and sour. Then students pick if they loved the sauce, liked it, or just tried it. Studer said, You have to be willing to try things, but the more you can learn about what you genuinely like, the more power it gives you to figure out how to make healthy food for yourself that tastes good to you. Olugbala said they cook with students at Soul Fire Farm for similar reasons. I feel like that just ties right into their own health, understanding the different things that they're putting into their bodies, they said. This is the cephalic phase insulin response (CPIR) I mentioned earlier. Let's learn the science of how the CPIR works. Within two minutes of tasting sweetness, the body releases insulin. The amount of insulin peaks at four minutes and returns to baseline levels within eight to ten minutes.

You don't just have one sip or one chew and go about your day. No, you drink that sweetened cup of coffee or diet soda over a long period, and each time you sip, your body continues to release insulin in response. I think back to the way I lived prior to understanding the clean fast. I was constantly nursing a sweetened coffee or a flavored water or a diet soda. I was pretty much CPIRing myself during all waking hours. There are numerous studies that illustrate the relationship between tasting sweetness or food-like flavors and CPIR (insulin release). At this point, it's important for you to understand that anxiety is reinforced by avoidance and thrives through your fighting it. Through your battle against it. Through your resistance. If this isn't crystal clear yet, it will be once you begin practicing the counterintuitive tools to follow. So to learn how to outsmart your brain's false fear messages and claim your calm, just read on. Another Shot of Adrenaline For an impressionist to paint from nature is not to paint the subject, but to realize sensations. --Paul Cezanne I was an overnight sensation. It's important to emphasize that an adrenaline surge does not equal anxiety. There have been multiple attempts to change this buy-and-bill system, but it remains in place. Prices Paid by Patients Patients with private insurance and Medicare have tiered co-payments. A typical tiered structure has 4 or 5 tiers, with co-payments rising as drugs become more expensive (Table 2).

What drugs are in each tier depends on the insurer or PBM and what drugs they have negotiated good prices on, put on the company formulary, and designated as preferred. The consequence is that for some drugs patient co-pays can be quite high. For instance, for many cancer chemotherapies the total price for the insurer could be $10,000 per month, with the patient responsible for $1,000 or even $2,000 per month. for generic drugs the co-pay can be small and sometimes free. Tiered Pharmacy Benefits Plan (United States) of drugs: Generic drug more glucose you need to administer to hold glucose levels steady, the more sensitive the body is to insulin. less glucose you need to administer to maintain the levels, the more resistant the body is to insulin. the same levels of insulin, much less glucose needs to be administered for elderly people than for young people, because elderly people are generally in an insulin-resistant state. our studies, when aging animals had their subcutaneous fat removed, they had insulin resistance typical of advanced age. contrast, old caloric-restricted animals had the same insulin sensitivity as young animals. group that I was holding my breath about was the group of old rats that had had visceral fat removed. our theory was correct, their insulin sensitivity would be similar to that of the young and the old caloric-restricted animals, and to our delight, they were. we had to do to achieve a healthy metabolism in rats that ate as much as they wanted and were also obese was to take out their visceral fat! knew we were onto something, and we wanted to see what would happen if we did a similar experiment with a model of diabetic rats. breed of lab rats known as Zucker fatty rats begins developing diabetes at two months, and by the time they're five months old, 100 percent of them will be diabetic. In addition, cooking gives children a chance to develop life skills. Just as we saw at the Youth Garden, there are plenty of things kids can do to help prepare food. At home, my kids add ingredients, stir, and chop with kid-friendly plastic knives. The possibilities expand even more as children get older.