Friday, August 28, 2015

Summer Stress Syndrome Part 1: Sugar, Fat, and Alcohol Can Make Us Feel Out of Control

Summer Stress Syndrome Part 1: Sugar, fat, and alcohol can make us feel out of control - time to recover!

Many of us look forward to the long, lazy days of summer.  We hope we will be relaxed, yet active, eat lots of fresh healthful foods, catch up on sleep, and share good times with friends.


Unfortunately, along with all the good things, summer can bring some stressful changes and challenges to our healthy lifestyle, too!  We sometimes call it "Summer Stress Syndrome”.  Visitors from out of town, parties, eating out at restaurants, road trips and vacations, late nights - while all of these can be fun, they can also mean loss of our healthy routines.  Constant temptations of ice cream, sweet treats,  alcohol, fried food, chips, side dishes full of mayo, etc, can trigger "addictive" responses in our brains - and leave us feeling out-of-control, tired, overwhelmed.  We may find it tough to preplan for healthy eating, tough to fit in regular exercise, tough to get enough quality sleep.  The combination of  “addictive”  treats, such as food and drink full of sugar/carbs, saturated fat, and alcohol, PLUS our fatigue, can lead us to make unhealthy choices.   Too much of this fun, and we can feel fried!  


Why is it so darn hard to control ourselves around certain foods, especially those full of sugar, and saturated fat?  Why can't we "just stop at one"? Are we just weak-willed, or is there a biological basis that is driving  addiction-like cravings?  


Seems like my patients are not the only ones asking these questions - there has been much research into the effects fat and sugar can have on our brains.  Here is a great article, with an interview with Dr. Louis Aronne:  http://www.forbes.com/sites/melaniehaiken/2013/08/21/the-real-secret-to-losing-weight-from-a-top-expert/ After analyzing a variety of weight loss diets, they determined that "a diet high in saturated fat and simple carbohydrates sets in motion a chain reaction of “metabolic dysfunction” involving the appetite  regulating hormones." Two particular hormones were affected by high fat diets: leptin and ghrelin. Leptin and ghrelin normally work to regulate our appetite to our bodies' needs, but these hormones malfunction when people eat high fat/high carb diets. A single high fat meal may make us feel "extra hungry" for up to 3 days! But even more concerning than the short term appetite problem - it turns out there may be long term damage in our brains. High fat/high carb diets may lead to “alterations in structural plasticity” - damage to nerve function in areas of the brain including the hypothalamus. According to Dr. Aronne in the article, "The evidence is quite convincing - eating fattening foods causes inflammatory cells to go into the hypothalamus…It's like your gas gauge points to empty all the time, whether or not the tank is full."
In other words, eating too much saturated fat and simple carbs can cause our brains to malfunction, so we never feel full and satisfied.  

For a more technical explanation, read the British Medical Journal article: http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8904778 "Excessive intake of certain macronutrients, such as simple carbohydrates and SFA (Saturated Fatty Acids) can lead to obesity and attendant metabolic dysfunction, also reflected in alterations in structural plasticity, and, intriguingly, neurogenesis, in some of these brain regions...appetite-related mediators, including circulating hormones, such as leptin and ghrelin, pro-inflammatory cytokines and the endocannabinoid intracellular messengers, are also being examined for their potential role in mediating neurogenic responses to macronutrients. "   We have called this the "Ice Cream Brain" effect, since ice cream is high in both saturated fat and sugar. Our appetites may be out of control up to three days after one very high fat meal - and knowing that may be enough to help us hold off on over indulging. And as bad as it is to feel out of control for three days after one splurge, it is even worse if we eat that way on a regular basis, since the damage can be more severe. This is serious, but the good news is that the damage may be reversible, if we make major dietary changes.


And it's not just fat - sugar by itself can be addictive as well.  Last fall the the New York Times ran an Op-Ed article called:  "Sugar Season.  It's Everywhere, and Addictive".  http://www.nytimes.com/2014/12/23/opinion/sugar-season-its-everywhere-and-addictive.html?smid=tw-share&_r=0&utm_content=buffercd6ae&utm_medium=social&utm_source=facebook.com&utm_campaign=buffer
The story discusses the theory that humans, until recently, faced food scarcity, and those who were 'wired' to like, love, or REALLY love sweets, tended to be those who survived - and passed those genes along to us 'moderns'.  


Unfortunately these genes - which can turn our brains into carb-craving machines - can really backfire in the modern world, where we are surrounded by an abundance (overabundance?) of super-delicious, 'hyper-palatable' treats.


The constant temptation of sweets everywhere - easy to reach, easy to eat -  can really 'light the fire' of cravings, and set that fire blazing.  The more we see/smell/eat, the more we want of the same.  And it's all there, in our neurochemistry.


This review article ( http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2235907/) states that "Based on the observed behavioral and neurochemical similarities between the effects of intermittent sugar access and drugs of abuse, we suggest that sugar, as common as it is, nonetheless meets the criteria for a substance of abuse and may be “addictive” for some individuals when consumed in a “binge-like” manner. This conclusion is reinforced by the changes in limbic system neurochemistry that are similar for the drugs and for sugar. "


This more recent  2013 review study (http://www.ncbi.nlm.nih.gov/pubmed/?term=Sugar+addiction%3A+pushing+the+drug-sugar+analogy+to+the+limit ) states that "evidence in humans shows that sugar and sweetness can induce reward and craving that are comparable in magnitude to those induced by addictive drugs."  Furthermore, "At the neurobiological level, the neural substrates of sugar and sweet reward appear to be more robust than those of cocaine."  Yes, you read that correctly, more addictive than cocaine!  And it concludes that the "biological robustness in the neural substrates of sugar and sweet reward may be sufficient to explain why many people can have difficultly to control the consumption of foods high in sugar when continuously exposed to them."  I'd say so!

And then there is alcohol. In addition to "non-nutritive" (empty) calories, alcohol can have a profound effect on us both psychologically and physically. Alcohol can decrease our inhibition (lead to loss of control and poor food choices), act as an appetite stimulant, AND promote fat storage and block fat oxidation (block fat-burning.) According to Dr. Arya Sharma and Dr. Yoni Freedhoff, in their book "Best Weight", "At 7 kcal per gram, one large glass of wine a night adds up to 65,700 kcal per year (the equivalent of nearly 9 kg [20 lbs] in weight gain)." It's all about choices, and how you are personally affected, so choose carefully, and know what you're up against.


So, what to do to control cravings?  The answer is not a simple, single trick - as much as we would love that - but the good news is that there ARE strategies to control cravings.  We employ a strategy we call “REMOVE AND REPLACE” to conquer cravings.  First it's important to identify what our individual 'triggers" are.  We need to know how WE respond as individuals to certain foods - know and accept our own ‘history’ with certain foods.    Next it's important to REMOVE these triggers from our immediate environment  (you can't eat something if it's not there).  And finally  we must REPLACE those treats with healthier, but still tasty, treats.  You can't take something away, without putting something else back!  If you REMOVE but don’t REPLACE,  the change simply won't be sustainable. We help our patients come up with specific ways to do this, every day.   Our goal is to help patients create - and SUSTAIN - successful healthy lifestyles.


There are additional strategies that can be very effective to help control cravings,  which are beyond the scope of today's blog.   And the best success comes from the creation of individualized strategies to address each person's unique needs.  Lifestyle change can be tough - be we can make it easier, and help improve success -  through education, problem-solving, coaching, and support.  


Weight management medications can also sometimes be helpful when ESTABLISHING new, healthy habits, and can even be useful to help SUSTAIN healthy lifestyle (more on this in future blogs, including using a modified Finnish Sinclair Method of intermittent medication to help control addictive responses to triggers.)  But again, that is too much to discuss in today's blog!

If you are struggling with cravings, and would like help, we'd love to help you!  Give us a call at (603) 379-6500, and read more about our program and strategies at healthyweightcenter.com . We can offer help in person with our fun and supportive team of nutrition and lifestyle experts, and can also offer help on the phone, or online, via Skype. Check out our recent blog on getting back on track: https://www.blogger.com/blogger.g?blogID=9135756041749750532#editor/target=post;postID=3248554749533813515;onPublishedMenu=allposts;onClosedMenu=allposts;postNum=1;src=postname


(Watch for Summer Stress Syndrome Part 2: When summer expectations don't match reality - should we beat ourselves up, or is there a better way?!)

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