Is Carbohydrate Addiction Real? Jacqueline A. Eberstein, R.N. Controlled Carbohydrate Nutrition, LLC British Medical Journal 2005 “Sugar is as dangerous as tobacco and should be classified as a hard drug. It is harmful and addictive.” Addictions Are Defined As: Dictionary.com- “The state of being enslaved to a habit or practice or to something that is psychologically or physically habit-forming…to such an extent that its cessation cause severe trauma.” Medical Dictionary-”Habitual psychological and physiological dependence on a substance or practice beyond one’s voluntary control.” American Society of Addiction Medicine Addiction is a chronic brain disorder characterized by what happens in the brain (midbrain). Effects neurotransmission and interaction in the reward circuitry of the brain. Leads to behaviors that replace healthy behavior. Previous memories of experiences with food, sex, alcohol and other drugs trigger cravings that renew the addictive behavior. Subconscious Pavlovian response. Science Daily, January 2012 West R, Theory of Addiction, Blackwell Publishing, 2006 How We learn to Love Sugar • Begins in the womb by swallowing amniotic fluid. May be an evolutionary process to distinguish taste to avoid poisons in the environment. In nature, poisons are not sweet. • Breast milk is sweet. Mom’s diet can affect the taste of amniotic fluid and breast milk. A varied diet gives child an experience with different flavors. Breast feed babies more likely to try different flavors compared to bottle feed babies. Sugar cont’d • Increased attraction to sweetness occurs during times of rapid growth but should decrease in teen years. • In mammals our sweet receptors evolved in environments that were low sugar and not adapted to the super sweet environment that we now face. This has created an abnormal reward signal in the brain that overrides control mechanisms and can create an addiction. Lenior M., Serre F,et al Intense Sweetness Surpasses Cocaine Reward PLoS ONE, 2(8) e698.doi: 10.1371. 2007 How Our Tastes Developed • After birth kids learn to distinguish bitter tastes. Helps kids to learn to eat foods that are not sweet that contain more nutrients. • In the past by the time babies were eating real food, they would have been much less attracted to sweetness. • Before the wholesale use of manufactured baby foods, which are made to be sweeter than the natural food (on purpose), kids were not as attracted to the taste of processed foods. This is no longer the case. • International attempts to lower the amount of sugar in baby foods from 30 to 10 percent was blocked by the US and the UK. Facts About Dopamine • Dopamine is an neurotransmitter involved in pleasure, learning, memory and motivation. • Beyond pleasure, dopamine alerts the brain to pay attention in order to survive. Dopamine can be increased because of danger, pain and high carb foods. • Far more complex than simply a feel good chemical. The Chemistry of Addiction • Communication in the brain from one nerve cell to another occurs by the production of chemicalsneurotransmitters such as dopamine, serotonin, norepinephrine etc. • When there is a deficit of dopamine receptors esp. D2A1 there is a pleasure deficit. • According to research done at the US Dept of Energy Brookhaven National Lab , obese subjects had fewer dopamine receptors. The higher the BMI, the fewer receptors they had. Addiction cont’d • People can be born with fewer dopamine receptors. Fewer dopamine receptors also occur in people with drug addiction. • Various substances can produce a rush of dopaminealcohol, sugar, nicotine, cocaine etc. increasing the experience of pleasure. • In people with fewer pleasure receptors, over time the dopamine response will slow requiring more and more of the needed substance to increase dopamine and experience pleasure. Rats Choose Sugar Over Cocaine • In lab rats symptoms of sugar addiction are similar to drug addiction: bingeing, withdrawal and cravings. • Dopamine may be released by increased glucose concentrations in the brain. • Sensory input from the mouth! • Lenior m, Serre F., et al, Intense Sweetness Surpass Cocaine Reward, PLoS one 2(8), e698. doi:10.1371 2007 Alcohol Addiction and Carbohydrate Intolerance • In the absence of adequate dopamine receptors resulting in a pleasure deficit, alcohol has been found to stimulate the fewer dopamine receptors setting up the pleasure response. • A particular dopamine receptor has been linked to addiction to alcohol, cocaine and nicotine. It has also been linked to carbohydrate cravings and compulsive eating. • In my clinical experience abnormal blood sugars occur in families with alcohol intolerance. • AA meetings –addicts turn to sugar when trying to gain control of other addictive substances. True of smokers and drug addicts trying to quit. Common Addiction Behaviors • More and more of the dopamine stimulating substance is required to experience pleasure. • Addicts are also driven to repeat the dose to avoid withdrawal. They need another “fix”. • The part of the brain (prefrontal cortex) responsible for judgment functions less well leading to diminished control of the damaging behavior. Behaviors cont’d • Preoccupation for getting and eating trigger foods. Closet eaters. Isolate themselves to partake in their addictive foods. • Repeated unsuccessful attempts to moderate intake. • Continue out of control use regardless of consequences. What Does Carb Withdrawal Look Like? • Neuroscientist, Bart Hoebel, noted that sugar withdrawal may not be as pronounced as it is in morphine but it is withdrawal. • Symptoms will temporarily resolve with another “fix”. • Symptoms can include fatigue, irritability, faintness, palps, headache, cold sweats, mental cloudiness, depression. • Symptoms usually resolve after a few days. Although preoccupation with the trigger foods can last longer. How to Break the Addiction Cycle? • How do alcoholics successfully give up alcohol? • Accept that you have an addiction and will always have it. • Abstinence from the addictive foods. • Accept that you can’t eat just one. • Embrace the idea that moderation does not work for you. Not because you are weak but because you are carb intolerant. Break the Cycle • Get on-going support. Get a buddy. • Eat properly to support a healthy blood sugar to diminish cravings and control hunger. Control the quality and quantity of carbs, eat protein regularly and don’t skip meals. • Learn to cope with stress. Exercise in rats can increase dopamine levels and increase the number of receptors. Break the Cycle • Avoid situations or people who are not supportive. • Seek comfort from something other than food. • Recognize that a Pavlovian response can continue but the mere thought of your addictive food does not mean you have to have it. The thoughts will stop when you no longer give in. Erase the connection between the stimulus and the response. Nora Volkow, director of the National Institute on Drug Abuse commenting on the recent research and the controversy about food addiction states: “The data is so overwhelming the field has to accept it. We find tremendous overlap between drugs in the brain and food in the brain.” Jacqueline A. Eberstein, R.N. Controlled Carbohydrate Nutrition, LLC 641 Lexington Ave., 15th Fl New York, New York 10022 www.controlcarb.com