The Biology of Food Addiction

The Calorie Hypothesis
Current view: Obesity is just lack of will power ...eat less, exercise more

This model fails because:

1. Our body's wise compensatory mechanisms defend against weight loss by decreasing energy expenditure and increasing appetite as we diet
2. High glycemic carbohydrates (like added refined sugars, sugar-sweetened beverages, refined grains, and starches) light up the nucleus accumbent - the brain's addiction center - promoting compulsive overeating of processed high glycemic foods
3. Multiple other factors actually regulate metabolism: dietary composition, gut microbiome, toxic exposures, infections, allergens, nutrient status, mitochondrial dysfunction, and imbalance of hormones and neurotransmitters.

"Caloric-restricte traditional "diets" exacerbate metabolic dysfunction and actually lead to OVEREATING over the long-term"

A more accurate view...

1. Poor diet quality, not calories is drive of obesity
2. All calories not created equal
3. Food is more than calories... it is information that programs genetic expression and changes metabolic state
4. Diets don't work because they are not addressing fundamental drivers of excess caloric intake: physiologic addiction to refined carbs and sugar! 

Sugar is eight times more addictive than cocaine!

Experimental research reveals a commonality between addition to sugar and cocaine.

• Both sweet taste and drugs of abuse, such as cocaine, stimulate release of dopamine in ventral stratum, critical in the process of reward-processing and learning
• Cross-tolerance and dependance are seen in both sugar consumption and drugs of abuse. This means that over time it takes more and more of each to get the desired effect.
• In one study, rats preferred saccharin over IV cocaine. In another, they chose sucrose over cocaine.

Compulsive Overeating Can Resemble Drug Addiction

Visceral Fat is "hungry" and may drive overeating behavior

• Visceral fat is fat that is stored around your organs
• These visceral fat cells are metabolically active and suck fuel out of your blood stream, making you eat more!
• They secrete hormones and cytokines that promote weight gain and inflammation
• Hormones such as adiponectin, insulin, resisting, leptin and MSH
• Cytokines such as IL-6, TNF-alpha, and other pro-inflammatory molecules
• Insulin release surges in response to high glycemic foods, creating more inflammation and obesity-promoting metabolism, more visceral fat storage = vicious cycle

Dietary composition more important than calories...

• In this large European study, increase in protein content and a reduction in the glycemic index led to an improvement in study completion and maintenance of weight loss.
• Another study shows a low-glycemic diet higher in fat and protein improves metabolic rate and energy.
• Mice fed high-GI diet had almost twice the body fat of those on the low-GI diet after 9 weeks.
• Athletes on ketogenic, high-fat diet had better performance, less fatigue

Bottom line: Latest research indicates that sugar consumption is an independent risk factor for many, if not ALL, chronic disease.

Do you need more reasons to stop eating sugar now?

Here are my recommendations for optimal health and weight:

1. Quality of foods is essential... low glycemic load, high micronutrient and phytonutrient and fiber content = eat a rainbow of colors in your foods.
2. Choose organic, pastured meats and wild fish
3. Eat more vegetables and low-glycemic fruits, like berries and green apples
4. Avoid all packages, processed foods - if it has more than 3-4 ingredients don't buy it!
5. Limit high glycemic starchy foods, like white potatoes and white rice
6. Eliminate gluten if you're sensitive and avoid ALL refined processed grains
7. Avoid all hydrogenated and trans fats. Use organic butter, ghee, coconut oil, olive oil, avocado and other healthy fats freely
8. Avoid genetically modified foods, like corn, soy, canola.

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Paleo Guide to Natural Sweeteners: The Good, the Bad and the Ugly

Inflammation is an essential part of the body's healing system. Without it, injuries would fester and simple infections could be deadly. Too much of a good thing, however, is downright deadly.

Chronic low-grade inflammation is intimately involved most chronic disease, including Alzheimer's, diabetes, heart disease, cancer, and autoimmune disease.  One of the underlying factors causing this increase in inflammation is our love affair with sugar.  We have been led to believe that if we switch to alternatives, we can go on with our sweet addiction and pay no health penalties down the road.  One of the very first things I teach patients to do is KICK THE SWEET HABIT!  If you go off sugar and all sweeteners for just 30 days, I promise you.... your body will adjust it's taste-meter so that a piece of fruit with have more flavor and sweetness than you've ever dreamed possible.  And if you do indulge in a glass of soda or something full of sugar, you just might spit it back out due to the sickening sweetness that your body had become accustomed to prior to your sugar detox.

But I do get questions all the time from patients... "If I do need to use a sweetener occasionally and sparingly... what are my best options?"  

Glad you asked!  So here's a Guide to Natural Sweeteners just for you...

The Good:  Natural - Use sparingly

• Stevia (organic green leaf or pure extract)
• Organic Local Raw Honey

The Fair: Natural - Use sparingly

• Dates
• Date sugar
• Coconut nectar
• Coconut sugar/crystals
• Fruit juice (only fresh squeezed, real, organic)
• Maple syrup 
• Palm sugar

The Bad:  Natural but recommend avoidance

• Agave
• Barley Malt
• Beet sugar
• Brown sugar/light brown sugar/muscovado
• Brown Rice Syrup
• Cane sugar or juice
• Caramel
• Carob syrup
• Corn syrup or solids
• Dextran
• Dextrose
• Ethyl Maltol
• Fructose
• Glucose/glucose solids
• Golden sugar
• Grape sugar
• High fructose corn syrup
• Lactose
• Levulose
• Maltitol
• Malt syrup
• Maltodextrin
• Maltose
• Mannitol
• Raw sugar
• Refiner's syrup
• Sorbitol
• Sorghum syrup
• Sucrose
• Xylitol (or other sugar alcohols, end in "-tol or -ose"

The Ugly:  Artificial - never consume

• Acesulfame K (Sweet One)
• Aspartame (Nutra-Sweet, Equal)
• Saccarin (Sweet'N Low)
• Stevia - white/bleached (Truvia, Sun Crystals)
• Sucralose (Spenda)
• Tagatose (PreSweet)

More on Truvia... the one you THOUGHT was ok

Is Truvia made from a leaf?  Well the answer is kinda, sorta.  Truvia has three ingredients:  erythritol, rebiana, and natural flavors.  Rebiana is made from the stevia leaf by soaking it in water.  Although Cargill whitewashes the process as similar to making tea, the truth is revealed in Coca Cola's patent where it outlines a 40+ step process that includes the use of acetone, methanol, ethanol, acetonitrile, and isopropanol.  I don’t know about you, but when I make a cup of tea, I’ve never used any of those ingredients.

The second fallacy of Truvia’s “guilt-free” naturalness is it’s main ingredient, erythritol.  Now while erythritol is a naturally-occurring sweetener found in many fruits, in nature it is present in such small amounts that Cargill manufacturers Truvia’s erythritol by chemically converting genetically modified corn into a food grade starch which it ferments to create glucose and then processes further to create erythritol.   All Natural?  Truvia sounds more like a GMO lab experiment than a sweetener straight from nature.  

But Dr. Jill, I need more carbs!

If you've gone Paleo and removed grains, legumes and refined foods from your diet, you don't have to let go of carbs altogether.   Here are some high carb delicious healthy veggie alternatives for you to munch on that are packed with nutrients...

1. Yam
2. Sweet potato
3. Parsnips
4. Cassava
5. Taro root
6. Plantain
7. Winter Squash
8. Onion
9. Beets
10. Carrots
11. Butternut squash
12. Rutabaga
13. Jicama
14. Kohlrabi or Purple kohlrabi (pictured)
15. Spaghetti squash
16. Turnips
17. Pumpkin
18. Zucchini

More references:

http://balancedbites.com/practicalpaleo

http://www.brucebradley.com/food/truvia-honestly-sweet-or-dishonestly-marketed/#sthash.q19Lnufg.dpuf

http://www.nytimes.com/2011/04/17/magazine/mag-17Sugar-t.html

http://www.huffingtonpost.com/kristin-kirkpatrick-ms-rd-ld/dangers-of-sugar_b_3658061.html

http://www.ncbi.nlm.nih.gov/pubmed/15328324

http://www.ncbi.nlm.nih.gov/pubmed/23762544

Could These Seven Foods Be Causing Your Weight Gain?!

Food Allergy "Fat"
"Fat" that comes with food sensitivities is a characterized by bloating and fluid retention that many people experience when they ingest these top seven food allergens.  Eating foods that interfere with our body’s chemistry causes tissue swelling, abdominal bloating or even facial puffiness that may have the appearance of real fat. In fact, it’s not unusual for a person to look ten to fifteen pounds heavier due to these nasty reactions.

The foods that people react to most commonly are also the most prevalent in the Standard American Diet (SAD, for short)  They are dairy, wheat, corn, sugar, soy, eggs and peanuts.  Many patients assume they aren’t “allergic” to these foods because they don’t experience the immediate histamine reaction we associate with an allergy, like hives, throat swelling or vomiting.  Another complicating factor is that these type of reactions often cause delayed symptoms, meaning that you may not feel badly for 12-36 hours. This makes such sensitivities extremely difficult to identify, particularly if your sensitivity is to a food that you eat on a daily basis. If you are constantly consuming wheat or dairy, for example, and having a low-grade reaction, you may not recognize this as your body’s distress signals. Instead you might assume they are totally unrelated chronic problems, like a eczema, migraines, fatigue, joint pain, or heartburn.

Virtually any food can cause these reactions — even “healthy” foods like citrus or bell peppers. Typically an individual will develop sensitivities to the foods he or she eats most often. Unfortunately the top seven - dairy, wheat, corn, sugar, soy, eggs, and peanuts - are the basis for most processed foods so most Americans are frequently exposed to them.   If we eat such foods on a daily basis, we may experience a near-constant state of reaction — including bloating and fluid retention. More serious, it may cause inflammation to the lining of the gut, upset your metabolism, create nutritional deficiencies, and blood sugar imbalances.  This can lead to food cravings, low energy, depression and even PMS!

When you eat reactive foods, they enter your bloodstream incompletely digested... as bigger particles that your body doesn’t recognize as food. This not only causes indigestion and gas within the gut, but may trigger release of cytokines and chemicals like adrenaline and histamine that set off an inflammatory response. As fluids rush into afflicted cells and are held in your tissues, swelling and abdominal bloating occur. Due to the fluctuation in endophrins that occurs in this "flight or flight response, you may find that you crave the foods your are most sensitive to.  The only real way to heal the gut is to eliminate these food triggers from your diet.

Elimination Diet to the Rescue!

One of the best ways to determine if you are having food reactions is an elimination diet.  Plan for a minimum of 3 weeks off all of the most common seven food allergens:  dairy, wheat, corn, sugar, soy, eggs and peanuts.  You will not be cured by that time, but you can determine which of these seven you are reacting to by adding them back into your diet one-by-one and seeing which one(s) you have a reaction to.

Another way to find the food culprits is to have your physician test you for IgG food sensitivities.  The elimination diet is the "gold standard" to determine what foods you are sensitive to but some patients prefer to have the data on paper before they start.  I use laboratories like, Genova Diagnostics, Metametrix, and US Biotek for this type of testing. 

Be aware that avoiding staple ingredients like wheat, dairy and corn syrup may require you to limit restaurant and packaged foods and to prepare most of your meals yourself.  I also recommend drinking plenty of water and getting regular exercise. Exercise will stimulate your metabolism and boost your energy level. It will also help flush excess fluids, burn calories and suppress your appetite, allowing you to experience even faster results.  Finding you have hidden food sensitivities may require you to adjust your eating, but when the inches start coming off and you feel better than you have in ages it will be worth all the effort!

Is Leaky Gut Causing Your Eczema or Psoriasis?

How Leaky Gut is linked to Skin Conditions, like Eczema & Psoriasis...

First a little background ... When the body doesn’t tolerate a food or has created antibodies to that food, ingesting it creates a chronic, low-level irritation or inflammation in the gut. Over time, with regular exposure, the irritation worsens and creates spaces between the cells. (Picture the walls of the gut, once tightly knitted together, looking more like swiss cheese!)   This is what is commonly known as, Leaky Gut.  These holes allow bacteria and their toxins, as well as incompletely digested proteins and fats, to “leak” out of the gut and into the bloodstream. Leaky gut syndrome (or increased intestinal permeability), sets the stage for myriad health problems, including rashes and skin problems, like eczema and psoriasis.  The skin is the body’s largest elimination organ so it’s not surprising that it comes under assault when toxins careen through the bloodstream.   A skin rash or eczema is a sign that the body is trying to slough out these toxins.  Some people will also experience increase in acne or be told they have "rosacea".   The body is trying to eliminate the problem the best way it knows how, and unfortunately you may see the nasty effects of leaky gut manifest in skin problems.  In addition, you might also experience gas, bloating, fatigue, sinus congestion, or foggy thinking.  Many other autoimmune conditions are also linked to the underlying problem of leaky gut.

An Elimination Diet Can Heal Your Skin Conditions

An elimination diet is the best way to pinpoint the offending food.   Here's some practical tips and recipes on how to get started.

Don’t know where to start? Foods that are most likely to wreak havoc on the gut include wheat and gluten, dairy products, sugar, soy, eggs, corn and yeast. If you’re highly motivated go off “the big five” for at least 3 weeks: wheat, dairy, sugar, caffeine and alcohol.

Although this isn't easy, you're guaranteed to notice the foods you are reacting to and 90% of patients feel dramatically better after a 3 week elimination plan. You might also consider keeping a food journal. Spend a week or two writing down what you eat and how your body feels in the minutes, hours and days afterward (e.g., an hour after you eat dairy, you feel bloated). It’s about pattern and symptom recognition and connecting the dots which in turn helps you decide which foods to eliminate first.

If you are a "show-me the data" type of person, there are labs that will test the blood for levels of IgG4 against certain foods and may be a predictor of what foods you are the most sensitive to.  In addition, if you have many reactions to a variety of foods, this is almost diagnostic for leaky gut syndrome and you should consult with a functional medicine doctor to start the healing process.