Carbohydrate Addiction -
Table of Contents What are Carbs? Are Carbs Addictive? What the Science Says Brain Chemistry of Carb Addiction The Most Addictive Carbs?
How to Kick Your Carb Addiction Carb Addiction: The Takeaway. Carbs short for carbohydrates , are one of the three macronutrients in food. The other two are fat and protein.
Each of these three nutrients can provide your body with energy calories. Carbohydrates are the basis of most foods in the standard American diet. All grains refined and whole , sugars, fruits, and veggies are predominantly carbohydrates. And your body breaks them all down into simple sugar glucose in your blood.
As with alcohol and other drugs, you can be addicted to carbs if your consumption meets the following criteria:. Addiction is similar across substances because it has to do with chemicals produced in your stomach and intestines that contribute to the production of dopamine in your brain.
Dopamine affects the pleasure and reward centers in your brain. When these centers are activated it causes cravings for more of the substance that activated them.
The science of carb addiction focuses on how the food we eat stimulates this circuitry. Scientists have only recently started to take the idea of food addiction seriously.
Their research is aimed at better understanding the underlying mechanisms contributing to the rise of obesity, diabetes, and other so-called diseases of civilization.
These include heart disease, chronic inflammation, osteoporosis, and many cancers. And of course, processed foods were non-existent.
Most food in the standard American diet is loaded with refined grains and added sugars—making carb addiction an important area of exploration. In fact, Americans consume nearly 3 pounds of sugar each week! From a dietary evolutionary perspective , carb addiction was a helpful survival trait during the vast majority of human history when sweet and carbohydrate-dense food was extremely rare in the natural environment.
Until a few thousand to a few hundred years ago, none of the fruits and vegetables that we have today existed. And the carb sources were fleeting and seasonal. Occasions when our ancestors came across a ripe fruit-bearing plant or a beehive were few and far between.
And these same binge-cravings occur in the bodies of us modern humans. For our ancestors, these rare sugar binges resulted in small amounts of stored fat.
Their bodies would eventually break down this fat to use as energy during leaner times and when fasting between successful hunts. Ketosis is the name for this metabolic state where we break down fat into fuel molecules called ketones.
An abundance of evidence suggests this vision of ancestral eating patterns: For nearly two million years, our ancestors were hyper-carnivorous apex predators who ate mostly meat.
And to feast on the small amount of carbs when available. If carb addiction is an evolved trait, then insulin is the key to understanding how it works on a chemical level in the body. The vast majority of the carbs we eat from grains, fruits, vegetables, and refined sugars get broken down into glucose simple sugar.
Glucose gets sent into our blood, raising blood sugar. The body responds by secreting insulin. The key to understanding carb addiction is that insulin triggers hormones and neurochemicals that both increase hunger and heighten the pleasure of sweet tastes.
Research on the brain chemistry of carb addiction looks specifically at these pleasure chemicals and the parts of the brain they activate. Hi-GI carbs are simple as opposed to complex carbs that spike your blood sugar more quickly than complex carbs that take longer to break down. Research also shows that repeatedly stimulating the reward center of your brain with high-GI carbs can reset your body fat levels.
To date, FA has not been classified in the Diagnostic and Statistical Manual of Mental Disorders 5 DSM-5 or in the International Classification of Diseases 6 ICD There is also ongoing discussion amongst clinicians as to how to refer to this disorder.
For the purposes of this paper, we will use the term food addiction to refer to dependency behaviors relating to sugar and processed foods, although it is increasingly being referred to as ultra-processed food addiction 7. FA is operationalized using the Yale Food Addiction Scale YFAS originally published in 8 and more recently the YFAS 2.
In , Schulte et al. reported pizza, chocolate, chips crisps , cookies biscuits and ice cream as the five most problematic foods for those with FA symptoms In recent years, increasing numbers of articles have described FA symptoms 11 , prevalence 12 , and possible mechanisms 13 , 14 in both animals and diverse human populations worldwide.
Two or three symptoms indicate mild SUD, four or five is moderate and six or more indicates severe SUD. The criteria include:. Similarly, there are six criteria from the ICD 6 , where three or more symptoms indicate SUD:.
Clinicians who work with persons with type 2 diabetes, obesity, and metabolic syndrome will likely recognize these behaviors in their patients, particularly those who struggle to follow nutrition and lifestyle advice consistently.
Prevalence estimates of FA are consistently highest in clinical samples of eating disorders EDs , which has led some authors to urge for ED screening and careful assessment before determining proper diagnosis and treatment It has been suggested that efforts to restrain eating, engage in compensatory behaviors e.
Meanwhile, it can be established that FA symptoms exist independently of ED symptoms, thus it can be conceptualized as a distinct disorder warranting targeted interventions 7 , More research is needed in this area. Several neurobiological mechanisms have been proposed to explain FA. Wiss et al. Similarly, Lindgren et al.
The authors add that further research is needed on the complex interaction between these processes and the hormones that modulate feeding behavior. Their discussion points to the challenge of designing interventions for FA because unlike other SUDs, total abstinence from food is not an available option.
No data have been presented for medication 21 , cognitive behavioral therapy 22 or brain stimulation Eleven obese women reported reduced cravings after infra slow brain training, however there was no follow up A low-calorie diet in 11 people with obesity and FA was found to normalize brain activation compared to people with obesity without FA.
However, follow up was only 3 months and no details of the diet were given In a randomized trial of probiotics for women with obesity and FA, the active treatment led to greater improvements in oxytocin levels and eating behavior, however there was no follow up.
Several authors affirm that low-carbohydrate approaches have therapeutic potential for treating FA symptoms The carbohydrate-insulin model of obesity supports observations of these foods triggering abnormal blood sugar and insulin spikes subsequently leading to changes in metabolic and neurobiological signaling Carmen et al.
published a case series of three patients with obesity, BED, and FA managed over 6—7 months on a low-carbohydrate ketogenic approach with no adverse effects They were followed up over 9—17 months. Interventions for FA must be able to demonstrate sustainable changes to symptoms and mental wellbeing.
FA recovery can be achieved without overemphasis on weight which can detract from the clinical utility of the construct as a behavioral disorder 7. In a recent poll of an online food addiction professional group, we found that 20 out 25 practitioners recommend low-carbohydrate or ketogenic food plans as part of their interventions unpublished data.
Although this proportion is subject to selection bias, it clarifies that carbohydrate restriction is a common clinical practice for the treatment of FA. Other practitioners include grains and fruit in their plans. No previous audits of practice outcomes in food addiction have been published to our knowledge.
Clinics in three locations [the United Kingdom UK ; North America NA ; Sweden SE ] already offering similar online programs for people with FA used the same measures for screening and follow up.
The ethics protocol for the National Health Service in the UK was reviewed and indicated that since the project was an audit of pre-existing routine practice and participants were self-referred, formal ethical review was not required. Participants in the programs typically made contact via social media and mailing list advertisements by the authors.
Participants were screened through online interviews by the appropriate clinician to confirm self-identified FA symptoms. None of the programs accepted people under 18 years of age, pregnant, having serious mental health problems requiring ongoing specialist psychiatric support, or any doctor requesting exclusion.
Each participant was given information about the program and audit and the opportunity to ask questions. Participants completed a consent form as part of the initial data collection to affirm that their anonymized data could be used in the audit of the programs. Participants' data were identified by a unique code to ensure anonymity.
An information sheet UK and protocols are included as Supplementary materials. Participants paid a reduced fee NA, SE or donation UK to participate.
Data collection points were scheduled before and after the online group and at 6 months, 1 year, 18 months and 2 year follow up. The current paper audits the data available to date, which is the initial pre- and post- active intervention data as of June Power calculations using the main outcome measures of the mYFAS2 32 and the short version of the Warwick Edinburgh Mental Wellbeing Scale 33 SWEMWBS indicated that 26 participants were needed to complete the 2-year follow-up in each location, for a total of 78 total participants.
Each location aimed to have 60—70 participants complete baseline data to ensure adequate numbers at 2-year follow-up.
The mYFAS2 is a short version of the YFAS 2. The mYFAS2 includes 13 items: one item for each of the 11 FA criteria in the DSM-5 for SUD and two items for the assessment of clinically significant impairment or distress.
One example item is: I ate until I was physically ill. There are eight frequency choices from never to every day. The mYFAS2 has good reliability and convergent and discriminant validity The scale can be scored as total number of criteria met 0—11, reported here or as an indication of a clinical diagnosis and severity.
A brief screening tool for FA symptoms based on the six ICD criteria for SUD 6 was developed by HG and JU as a simple tool for clinicians. CRAVED, which has not been formally validated, is described and included in the Supplementary materials.
Participants were asked to rate whether they had experienced the symptom in the last month yes or no, possible score 0—6. An example item is: I had such a strong desire or sense of compulsion at the thought of eating these foods, that I could not resist the urge to eat them.
A score of 3 or more out of six indicates a potential SUD according to ICD 6. The SWEMWBS is a short version of the Warwick-Edinburgh Mental Wellbeing Scale The scale was developed to monitor mental wellbeing in the general population and for the evaluation of programs designed to improve mental wellbeing.
There are seven statements relating to functioning such as I've been thinking clearly with five response categories from none of the time to all of the time. The measure has good construct and external validity and test-retest reliability Scores range from 7 to 35, higher scores indicating more positive wellbeing.
The England population mean is The following data were also collected: age, gender, and weight kg. The online survey took ~10 min to complete.
The programs consisted of 10—14 weeks of 90—min sessions in groups of 11—40 participants. The variation is due to each location having their own set of program materials and methods. Sessions consisted of educational content delivered live or pre-recorded, coaching discussions, and assigned reflections.
A comparison of the three group programs and an example food plan UK are included in the Supplementary materials. Abstinence from sugar, grains, processed food and any foods the individual participants were unable to moderate e.
Following the active program phase, participants joined a monthly min facilitated online support group, which will continue for 2 years.
All groups also established independently their own support group chats and online meetings. Participants entered their data into online forms which were analyzed using R v4. P -values were calculated using the Wilcoxon rank sum test with continuity correction, and a value below 0.
Summary statistics were calculated using random effects models and the DerSimonian-Laird estimate 35 and visualized as forest plots using the meta package, version 4.
Not all participants were available for follow-up and a small number of participants who completed follow-up data could not be matched to baseline data due to them entering unidentifiable codes.
There were 32, 33, and 38 sets of matched data for UK, NA, and SE, respectively. Graphs shown in Figure 1 through Figure 4 show all available data points for pre -and post-intervention data, including participants who were not available to follow up and unmatched participants but all analyses of the change from pre- to post-intervention were carried out on the matched pairs of data.
Table 1 shows retention data to date. Figure 1. Line and forest plots for mYFAS2 symptom score. Dark green indicates improved scores, light green indicates worsening score or no change. Dark gray data points without a line represent people who started but did not finish or who completed a follow up questionnaire but could not be matched with a starting questionnaire.
Table 2 summarizes the UK data. Decrease in mYFAS2 scores was significant mean reduction 1. Reduction in CRAVED was significant mean reduction 1. Reduction in weight was also significant Mean loss 2. Table 3 summarizes the NA data.
Reduction in mYFAS2 scores was significant mean reduction 1. Reduction in weight was also significant mean loss 4. Table 4 summarizes the SE data. Reduction in mYFAS2 scores was significant mean reduction 2.
Reduction in CRAVED was significant mean reduction 0. Reduction in weight was also significant mean reduction 1. Figures 1 — 4 show line plots and forest plots for mYFAS2 score, CRAVED score, SWEMWBS score and weight. The line plot shows change over time for each participant across study locations.
Improvement e. Random effects forest plots calculate the overall change across all three settings. Figure 2. Line and forest plots for CRAVED. undeniable cravings that had been running and ruining our lives for so long.
We soon discovered that by changing how often we ate carb-rich foods ,. we were able to eat the foods we loved everyday while losing weight. Without having to give up the foods we loved, we lost a combined weight.
Now, we have remained slim, trim, and healthy, struggle-free, for more. Carbohydrate Addiction: We know what causes it and we know how to stop it How do I stop the. for good? Stories of.
Success and. Heller Help:. Books for. Carb Addicts.
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