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December 13, 2010

The Integrated Supplements Newsletter - A Diet For Long-Term Weight Control And Optimal Health Part 1 - Sugars And Carbohydrates From An Addiction Perspective

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How can they say my life is not a success?
Have I not for more than sixty years got enough to eat and escaped being eaten?

–Logan P. Smith

HeaderPicAug10 For the vast majority of human history a lack of food was a profound and constant threat to survival. As such, early in its evolutionary history, the human brain developed powerful pleasure signals to reward, and thus ensure, the consumption of fat, sugar, salt, and protein – some of the most important nutrients needed to ward off starvation.

But though modern humans have been bestowed with the same genetics and brain circuitry as our distant ancestors, those of us living in industrialized nations today rarely face the imminent threat of starvation. On the contrary, most of us find ourselves amidst an overwhelming abundance of food, and immersed in a culture which greatly encourages over–consumption.

Anthropologists have also noted that modern–day humans expend far less effort procuring and preparing foods (and engage in less physical activity overall) than either our foraging or hunter–gatherer ancestors. With our brains still wired to prevent starvation – leading to a seemingly limitless appetite for fat, sugar, salt, and calories – and with a decrease in the amount of energy expended through physical activity, the stage is thus set for the modern sort of weight problems which have spiraled into a worldwide obesity epidemic.

If the evolutionary deck is, indeed, stacked against us in such a way, it’s easy to see why the passive acceptance of the cultural status quo can lead to weight gain. But an important question naturally arises: Why do most people have such a hard time losing weight – even when they consciously try to do so?

It’s clear that conventional diet wisdom has failed in stemming the tide of overweight and obesity. Numerous studies have shown that, despite their concerted efforts, most people can’t seem to control their diets sufficiently enough to achieve meaningful long–term weight loss. Americans contribute over 68 billion dollars each year to the “diet industry,” but, as we have seen previously, even reasonable interventions geared towards calorie restriction and portion control are notoriously ineffective. Ironically, most such dieting efforts ultimately result in increased weight gain.

In hunter–gatherer societies – where food is less prevalent, and requires more energy to obtain than in industrialized societies – obesity is almost non–existent. And invariably, when individuals from these cultures relocate to industrialized nations, or when these cultures adopt a western style of eating and food distribution, obesity rates rise dramatically. These facts can make it appear as if obesity will be an inevitable problem as long as we have unlimited access to cheap, calorie–dense food.

In a more optimistic sense, however, it’s likely that when we rectify the pathological and excessive cravings triggered by modern foods, the allure of these foods will diminish despite their availability. In other words, by way of analogy, we’ll find that the mere availability of food doesn’t cause obesity any more than the availability of liquor causes alcoholism.

Along these lines, part of the answer to the obesity epidemic can likely be found by investigating how modern food alters brain chemistry – in particular, the effects of foods on addiction biology – i.e., cravings, drive, and biological reward.

From the scientific literature, we find every reason to believe that when the body is fully nourished with the proper balance of all necessary nutrients, the biological cravings for food are blunted, appetite is controlled, and compulsive consumption of food naturally ceases – even in the midst of unlimited food availability.

In the previous edition of The Integrated Supplements Newsletter, we discussed the role of the amino acid, neurotransmitter, and food additive, glutamate in perpetuating the addition–like potential of food. In this, and subsequent editions, we’ll similarly examine the potentially–addictive role of sugar and carbohydrates. We’ll see how a lack of many nutrients exacerbates sugar’s addictive and health–compromising potential, and ultimately, in this series of articles, we’ll examine ways to construct a diet geared towards long–term weight control and optimal health.

A Brief Glossary of Sugar:

Monosaccharides – single, unlinked sugar molecules. Examples are: glucose, fructose, ribose, and galactose.

Disaccharides – Two chemically–bound sugar molecules. Examples are: sucrose, lactose, and maltose.

Glycogen – A storage form of sugar found in the body’s cells.

Glucose – The predominant sugar used as a fuel source for the body’s cells (especially the brain and skeletal musculature). Starches (in bread, pasta, potatoes, etc.) ultimately break down into glucose. Some starches are digested rapidly, and elevate blood glucose and insulin nearly as much as pure glucose. In diabetes, where glucose can’t be utilized properly, blood levels of glucose often rise to unnaturally–high levels.

Fructose – Fruit Sugar. Fructose is metabolized and stored by the liver in the form of glycogen. Liver glycogen is formed from fructose and is released as glucose to serve the fuel needs of the rest of the body (e.g., the brain and muscles) during stress, exertion, exercise, starvation, etc. Fructose is also unique in that its consumption doesn’t lead to dramatic elevations in blood sugar or insulin release as the consumption of glucose and starch often do. It’s important to realize that although fructose is called fruit sugar, fruits actually contain varying mixtures of fructose, glucose, and sucrose.

Sucrose – Table sugar. Sucrose is a disaccharide consisting of nearly equal amounts of glucose and fructose.

High–fructose corn syrup – A mixture of fructose and glucose manufactured from corn. HFCS is said to contain either 42% or 55% fructose depending upon the application in which it’s used – the remainder is glucose. Though many people believe that HFCS is comprised solely of fructose, its composition is reasonably similar to sucrose.

Is Sugar Addictive?

As sugar provides a quick and efficient energy source for the brain, it’s not surprising to find that sugar consumption can trigger the release of powerfully pleasurable brain chemicals. Numerous animal studies even provide strong evidence that sugar consumption triggers many of the same neurochemical and behavioral effects as addictive drugs. For example, intermittent sugar intake triggers increased signaling of dopamine and endogenous opioids similarly to drugs of abuse:

Study Link – Excessive sugar intake alters binding to dopamine and mu–opioid receptors in the brain.

Quote from the above study:

…intermittent, excessive sugar intake sensitized D–1 and mu–1 receptors much like some drugs of abuse.

Study Link – Daily bingeing on sugar repeatedly releases dopamine in the accumbens shell.

Quote from the above study:

These results suggest another neurochemical similarity between intermittent bingeing on sucrose and drugs of abuse: both can repeatedly increase extracellular DA in the NAc shell.

Sugar consumption is even associated with relapse and withdrawal symptoms similar to those associated with addictive drugs:

Study Link – Implications of an animal model of sugar addiction, withdrawal and relapse for human health.

Quote from the above study:

The study demonstrates that the effects of sugar addiction, withdrawal and relapse are similar to those of drugs of abuse.

Study Link – After daily bingeing on a sucrose solution, food deprivation induces anxiety and accumbens dopamine/acetylcholine imbalance.

Quote from the above study:

Bingeing on sugar may activate neural pathways in a manner similar to taking drugs of abuse, resulting in related signs of dependence.

But, unlike the diet of laboratory animals, the human diet is governed by numerous societal and psychological inputs not accounted for in animal studies. For this reason, some scientists have raised criticism that animal studies of sugar addiction like these aren’t directly applicable to humans:

Study Link – The plausibility of sugar addiction and its role in obesity and eating disorders.

These criticisms have merit – where human research in this area is lacking, it’s premature to assume, for example, that the effective treatment for binge eating (or obesity) will directly parallel the treatment for drug addiction (e.g., treatments such as psychological counseling, 12–step therapy, pharmacological intervention, etc.). The neurobiological addiction research as relates to food does, however, give us important clues as to how to successfully navigate what some researchers have called our “toxic food environment.”

Article Link – Eating disorders, obesity and addiction.

Quote from the above study:

Interest in obesity as a brain disease should not detract from a public health focus on the ‘toxic food environment’ that is arguably responsible for the obesity epidemic and related nutrition–based chronic disease.

Neurochemical Reasons Why Diets Don’t Work

Seemingly irresistible cravings for sugar and carbohydrates aren’t the only reasons why diets fail, but understanding our bodies’ response to sugar can offer valuable insights into how to avoid the type of “relapse” which undermines most attempts at long–term weight loss.

For years, researchers from Princeton University have conducted groundbreaking research into the animal model of sugar addiction. While it’s been known for some time that laboratory animals will consume increased amounts of sugar when it’s available to them, and that these animals will exhibit some symptoms of withdrawal when denied access to sugar, only recently have researchers found that feeding sugar in a certain fashion can lead to the sort of amplified cravings characteristic of addiction:

Study Link – Evidence for sugar addiction: Behavioral and neurochemical effects of intermittent, excessive sugar intake.

As the above study illustrates, one of the requirements for the development of sugar addiction in animals is that the sugar be supplied intermittently. The biological reward associated with sugar consumption actually increases after periods of abstinence. In the above study, animals were food–deprived for 12 hours, followed by 12–hour access to food and a sugar solution. The animals in the above study drank the sugar solution copiously, especially when it first became available each day. In all, these animals consumed just as much sugar as animals receiving unlimited access to sugar. The researchers likened this effect to the bingeing behavior which is characteristic of substance abuse.

The animals with intermittent access to sugar exhibited a more pronounced dopamine and opiod–like response to sugar during their bingeing period. The phenomenon whereby this sort of restricted access to a substance creates a greater biological response when the substance is re–introduced is known as the deprivation effect, and is common with abused drugs. Interestingly, when animals are given only intermittent access to sugar, their motivation to obtain, and their consumption of, sugar increases as the length of the deprivation increases. The animals in the above study had a greater biological response to sugar after 30 days of abstinence compared with abstinence of one week or one day.

Quote from the above study:

…the motivation to obtain sugar appears to “incubate”, or grow, with the length of abstinence. Using operant conditioning, [other studies] find that sucrose seeking (lever pressing in extinction and then for a sucrose–paired cue) increases during abstinence in rats after intermittent sugar access for 10 days. Remarkably, responding for the cue was greater after 30 days of sugar abstinence compared with 1 week or 1 day.

This may be one clue as to why restrictive diets are so notoriously ineffective and even counterproductive. The restriction of important nutrients (i.e., sugar) which our brain is designed to crave seems to increase the craving and reward of these substances over time – and such restriction seems to weaken our resolve on a fundamental biological level. As evidence, food deprivation has been shown to increase the sensitivity to, and intake of, drugs of abuse:

Study Link – Augmentation of drug reward by chronic food restriction: behavioral evidence and underlying mechanisms.

Quote from the above study:

…chronic food restriction augments the rewarding (i.e., threshold lowering) effect of diverse drugs of abuse. Further, the effect is attributed to increased sensitivity of a neural substrate, rather than a change in drug bioavailability or pharmacokinetics, because it is preserved when drugs are injected directly into the lateral cerebral ventricle (intracerebroventricularly).

Study Link – The role of food deprivation in the maintenance and reinstatement of cocaine–seeking behavior in rats.

Quote from the above study

When the rats were partially food–deprived every third day, cocaine infusions more than doubled during that session.

And particularly interesting human studies in the psychiatric literature have found that acts of self–control require surprisingly high amounts of brain energy in the form of glucose. Because acts of self–control consume glucose, self–control ability becomes progressively worse as this fuel is depleted. In the following study, administration of glucose–containing drinks was able to improve performance on tests requiring self–control, and even improved aspects of pro–social behavior (subjects who consumed glucose reported being more likely to help both friends and strangers in need).

Study Link – Self–control relies on glucose as a limited energy source: willpower is more than a metaphor.

Quote from the above study:

The present work suggests that self–control relies on glucose as a limited energy source. Laboratory tests of self–control (i.e., the Stroop task, thought suppression, emotion regulation, attention control) and of social behaviors (i.e., helping behavior, coping with thoughts of death, stifling prejudice during an interracial interaction) showed that (a) acts of self–control reduced blood glucose levels, (b) low levels of blood glucose after an initial self–control task predicted poor performance on a subsequent self–control task, and (c) initial acts of self–control impaired performance on subsequent self–control tasks, but consuming a glucose drink eliminated these impairments.

From studies such as these, we can see reasons why diets geared around willpower, (e.g., overly–restrictive diets, crash–diets, calorie counting, etc.) are apt to stall quickly in their effectiveness. First of all, our willpower simply becomes less–and–less effective the more we restrict our diet.

Secondly, via repeated dieting attempts (i.e., alternating periods of restriction and access), the brain may eventually become hypersensitive to the rewarding effects of food (or possibly, even other addictive substances).

Animal studies in which rats were made “sugar–addicted” by intermittent access to sugar showed that these rats also became hyper–sensitive to the effects of amphetamine. Sugar–addicted mice exhibited a greater degree of hyperactivity in response to a dose of amphetamine than non–sugar–addicted mice:

Study Link – A diet promoting sugar dependency causes behavioral cross–sensitization to a low dose of amphetamine.

Quote from the above study:

These results suggest that a diet comprised of alternating deprivation and access to a sugar solution and chow produces bingeing on sugar that leads to a long lasting state of increased sensitivity to amphetamine, possibly due to a lasting alteration in the dopamine system.

A Recipe For Weight Gain

We can see how restrictive diets may lead ultimately to weight gain by looking at the brain changes which take place in response to caloric restriction. Studies suggest that animals who have lost weight via caloric restriction subsequently exhibit an enhanced dopamine response, and a decreased acetylcholine response when ingesting sucrose. In other words, in animals that have lost weight through caloric restriction, the addictive potential of sucrose (mediated by dopamine) is enhanced, while the satiating potential of sucrose (mediated by acetylcholine) is reduced:

Study Link – Underweight rats have enhanced dopamine release and blunted acetylcholine response in the nucleus accumbens while bingeing on sucrose.

Quote from the above study:

These findings suggest that when an animal binges on sugar and then loses weight, the binge releases significantly more DA and less ACh than when animals are at a normal body weight.

Both of these factors set the stage perfectly for not only breaking a calorie–restricted diet, but for bingeing – i.e., consuming an extreme excess of calories in a short period of time – as the body tries to overcompensate for what it perceives as the threat of starvation.

It’s likely that a similar phenomenon occurs in the real world environment – the scientific literature clearly shows that, ironically, the long–term result of weight–loss efforts is often increased weight gain. Such a paradoxical outcome may even occur with the majority of calorie–restricted diets:

Study Link – Medicare's search for effective obesity treatments: diets are not the answer.

Quote from the above study:

The authors review studies of the long–term outcomes of calorie–restricting diets to assess whether dieting is an effective treatment for obesity. These studies show that one third to two thirds of dieters regain more weight than they lost on their diets, and these studies likely underestimate the extent to which dieting is counterproductive because of several methodological problems, all of which bias the studies toward showing successful weight loss maintenance.

Glutamate Signaling in Caloric Restriction

The human brain constitutes only 2% of the body’s mass, yet consumes 20% of the body’s calories. With glucose being the major fuel source for the brain, glucose deprivation is profoundly stressful to the body, and can exacerbate the biological stress response at the most fundamental cellular level. Studies have found, for example, that glucose deprivation can result in excitotoxicity. In other words, in the absence of an adequate fuel source, the stimulation of the brain’s neurons can injure the neurons to the point of cell death:

Study Link – Glucose deprivation neuronal injury in cortical culture.

Quote from the above study:

These observations support the hypothesis that glucose deprivation–induced cortical neuronal injury is largely mediated by NMDA receptors…

Most people realize that they can become cranky and irritable when their blood sugar dips too low – and we’ve seen, the cellular effects of low blood sugar (i.e., hypoglycemia) can manifest as negative mood changes, weakened self–control, and impaired social behavior. But in the long–term, caloric restriction (which almost necessarily includes sugar/carbohydrate restriction) may be associated with neuronal dysfunction and degenerative brain disease. We’ve seen in previous Integrated Supplements Newsletters that, although it may extend lifespan in some lower species, long–term caloric restriction isn’t likely to be a viable anti–aging strategy in humans. Research and empirical evidence seems to suggest that long–term caloric restriction may, instead, increase the risk of neurodegenerative disorders:

Study Link – Energy intake and amyotrophic lateral sclerosis.

Quote from the above study:

Roy Walford, a physician and scientist who pioneered research on the anti–aging effects of caloric restriction and subjected himself to a low–energy diet, recently died from amyotrophic lateral sclerosis (ALS). Information from his case, epidemiological findings, and recent controlled studies in mouse models of ALS suggest that low–energy diets might render motor neurons vulnerable to degeneration, whereas high–energy diets are ameliorative.

Such disorders are characterized, in large part, by excessive glutamate transmission via the NMDA receptor. In previous articles, we’ve seen that the same sort of excessive glutamate transmission is also associated with anxiety, depression, and addiction. In keeping with this mechanism, the following study found evidence that the increased reward of addictive drugs in the context of food restriction could be mediated by increased NMDA signaling:

Study Link – Chronic food restriction: Enhancing effects on drug reward and striatal cell signaling.

Quote from the above study:

Chronic food restriction (FR) increases behavioral sensitivity to drugs of abuse in animal models and is associated with binge eating, which shares comorbidity with drug abuse, in clinical populations… Of particular interest is an upregulation of NMDA receptor–dependent MAP kinase and CaM Kinase II signaling, CREB phosphorylation, and immediate–early and neuropeptide gene expression in nucleus accumbens (NAc) which may facilitate reward–related learning, but also play a role in the genesis of maladaptive goal–directed behaviors.

In all, we can see that the body often views carbohydrate and sugar restriction as profoundly threatening. If we know that sugar restriction and caloric restriction sensitize the powerful addictive biology which is hardwired into our brains, then the ultimate answer to “sugar addiction” (and, in all likelihood, overall weight loss), lies not in Draconian restrictions in our diets, but in consuming all of the elements our body so values (sugar, fat, calories, protein, and salt) in the context of all of the nutrients needed for their proper metabolism. This is likely to naturally regulate our appetite, and foster weight–loss without requiring the sort of Herculean willpower often associated with dieting.

In subsequent editions of the Integrated Supplements Newsletter we’ll examine the metabolism of sugar and carbohydrates, with perspective on the true role of sugar in obesity (and related disorders such as diabetes). We’ll also examine which types of carbohydrate–containing foods are the best choices for optimal human metabolism, and which types may be uniquely fattening via their ability to trigger our primordial addictive biology. Our distant ancestors had no choice but to satisfy their cravings for sweets through whole, micronutrient–dense food, and we’ll examine how some of the micronutrients and phytonutrients found in whole food may serve to simply make sugar an important nutrient, instead of the addictive substance it’s become in our modern diet.

 

About Us: At Integrated Supplements, our goal is to bring you the wellness information and products you need to live your life to the fullest. We are dedicated to producing the highest–quality, all–natural nutritional supplements; and to educating the world on the health promoting power of proper nutrition. You can find out more by visiting: www.IntegratedSupplements.com

 

These statements have not been evaluated by the FDA. No Integrated Supplements product is intended to diagnose, treat, cure or prevent any disease.

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