Effective strategies for combating carb cravings
Yesterday in practice I saw a female patient who, among other things, was troubled by the fact that she craved sugar “like you wouldn’t believe”. It is my experience in practice that many individuals with sugar cravings view it as a sign of weakness on their part. However, food can have powerful addictive qualities, and the physiological processes here can sometimes be overlooked. Often, taking an approach designed to normalise and balance whatever physiological issues are at the root of such food cravings can be extremely effective in stopping the cravings in their tracks.
One potential and important cause of sweet cravings is episodes of low blood sugar (hypoglycaemia). If blood sugar levels get low, it’s natural for the body to crave foods that replenish sugar quickly into the blood stream (e.g. chocolate). While this can happen at any time, one particular time of day where such cravings are common is the mid-late afternoon. It may be that these individuals are suffering from a blood sugar low caused by the body’s reaction to a blood sugar high that can come after lunch (particularly something like a sandwich). My sugar-craving patient yesterday, as it happens, found that her symptoms were most intense at this time.
The cornerstone of combating such cravings is a diet that helps stabilise blood sugar levels. This means, for the most part, regular meals/snacks based on foods that tend to release sugar quite slowly into the bloodstream. A relatively protein rich, carb-restricted ‘primal’ diet tends to work very well here.
In addition, certain supplements can help. Sometimes, for instance, it can help to take some chromium. Chromium helps to stabilise blood sugar levels, and has been shown to reduce hunger and food cravings as a result. See here for more on this.
Another nutrient that can help combat sugar cravings is the amino acid glutamine. Within the body, glutamine can be converted into brain chemicals such as gamma aminobutyric acid (GABA) and gamma hydroxybutyrate (GHB) which seem to have the capacity to reduce the desire for certain foodstuffs, namely sugar and alcohol.
By pure coincidence, I recently bought some glutamine to try it. Yesterday, I dissolved 1 teaspoon of glutamine powder in 500 mls of water to sip throughout the day. Now, it might have been my imagination/placebo response/whatever, but I noticed a distinct reduction in my desire for carbohydrate throughout the day. I went out for dinner last night with some friends, and was offered a dessert (baked cheesecake) as part of a set menu I’d opted for. When the dessert arrived, I had zero desire to eat it. This is strange because while I don’t seek out this sort of food, once it’s plonked in front of me I usually am able to muster enough enthusiasm to eat it (or at least some of it).
The value of stabilising blood sugar and combating cravings should not be underestimated, because I’ve seen it work well in individuals diagnosed with the condition bulimia nervosa (characterised by bingeing and purging). Purging has been shown to have the capacity to induce hypoglycaemia, which can lead to bingeing, typically on carbs, and so the cycle repeats. Below, I have pasted in a previous article on the dietary management of bulimia. In addition to a blood sugar stabilising diet with some additional chromium, it might be that supplementation with glutamine might help break the bingeing/purging cycle.
Why bulimia is not all in the mind, and the dietary approach that can put a stop to this condition - 29 February 2004
The National Institute for Clinical Excellence (NICE) here in the UK recently published a report which stressed the role of psychological therapies in the treatment of eating disorders such as bulimia and anorexia nervosa. However, while conventional wisdom has been that these conditions are essentially mental disorders for which a head-first approach should prevail, mounting evidence suggests that disordered eating may be rooted in issues that have more to do with the body, than the brain. In particular, studies suggest that the bingeing of food typically exhibited by sufferers of bulimia may be manifestations of biochemical processes gone awry. Scientific research shows that dietary modification can put pay to the symptoms of bulimia, and is an approach that may be considered to be a no-brainer for those seeking an effective treatment for this condition.
One common cry heard from those suffering from bulimia is that once they start eating, they can struggle to stop. While any food may be the object of a bulimic’s desire, experience shows that most gravitate to carbohydrate-based foods rich in sugar and/or starch. The sort of carb-fest many find themselves engaged in will generally ignite a skyrocketing of blood sugar levels. There is some evidence that this surge in the system has the potential to skew the delicate biochemistry of the brain, and this may have repercussions for both appetite and mood.
In one study published in the journal Biological Psychiatry [1], an injection of sugar was found to provoke feelings such as depression and anxiety in a group of bulimic women, while a placebo injection did not. Interestingly, women subjected to an influx of real sugar also led to an upsurge in their urge to binge. The precise biochemical mechanism responsible for this phenomenon is unknown. However, the results of this study do at least seem to lend some credence to the common bulimic experience of getting stuck on a roll.
Another hallmark symptom of bulimia is the purging of food from the body, for which induced vomiting and/or laxatives are commonly employed. Interestingly, a study published in the International Journal of Eating Disorders found that purging tends lead to sub-normal levels of blood sugar in the body [2]. The relevance of this is that when blood sugar levels are low, there is a tendency for the body to crave carbohydrate foods, and usually plenty of them too. The available evidence suggests that those suffering from bulimia can be caught in a viscous cycle fuelled by highs and lows of blood sugar.
In practice, I have seen many individuals break this cycle by adopting a diet designed to get blood sugar levels on an even keel. Three meals are day are recommended, and these are best based on relatively slow sugar-releasing foods such as meat, fish, eggs, vegetables and a limited amount of unrefined starch-based foods such as potato, brown rice and wholemeal pasta. Snacks of fresh fruit and/or nuts had between meals can also be useful for keeping blood sugar levels buoyant. Scientific validation for such an approach comes in the form of a study in which 20 bulimic women put on a sugar-stabilising diet [3]. Within three weeks, all 20 of the women had stopped bingeing, and remained free from binges in the long term too. The evidence suggests that a nutritional approach often proves effective for curbing uncontrolled eating, and promises significant benefits for individuals keen to get bulimia out of their system.
References:
1. Blouin AG, et al. A double-blind placebo-controlled glucose challenge in bulimia nervosa: psychological effects. Biol Psychiatry. 1993;33(3):160-8.
2. Johnson WG, et al. Repeated binge/purge cycles in bulimia nervosa: role of glucose and insulin. Int J Eat Disord. 1994;15(4):331-41
3. Dalvit-McPhillips S. A dietary approach to bulimia. Physiol Behav 1984;33:769-775
Published June 25, 2009 . Filed under: Brain and Behaviour, Healthy Eating, Low-Carbohydrate/Carbohydrate Restriction, Nutrients and Supplements, Women's Health
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An excellent topic John. I have found no other site to compare with this.
It is interesting that in your fifth paragraph in which you introduce the factor of glutamine that the words sugar and alcohol appear together. Elsewhere on the web is postulated an opinion that the binge culture evident in drinking may have something in common with the rising presentation of obesity and diabetes, and that facets of the modern diet may be one degree of commonality.
Taubes has indicated that incidence of diabetes among monks renowned for production (and one imagines consumption) of strong beer possibly implicates alcoholic beverage as one possible factorial in diabetes.
Each of the two facets of binging suggest some mechanism(s) resulting in loss of self control in relation to consumption. Likewise does the incidence of humans weighing in at 200kg.
The possible corrective pathways of glutamine may cast some light?
June 25, 2009 @ 8:07 am
Very interesting!!!
Can you advise the kinds of foodstuffs we typically find chrormium and glutamite it? Would it be in nuts and protein rich foos by any chance?
I personally find it so much easier to resist my favourite ice-cream or other white sugar laden snacks when I have avoided carb rich food & drink earlier in the day or during the previous 24 hours or so. I find this especially true of refined carbs, which appears to have become one of the acceptable poisons of the modern diet (Most definitely not primal!!)
I usually have 2 - 3 cups of coffee during the day and in an attempt to at least reduce the refined carbs, always take it with 2 - 3 sachets of raw cane sugar. When I used to have white sugar, I would never go over 2 sachets as it’s sweeter - but allow myself more raw cane due it’s reduced G.I. even if it does mean I consume more calories overall!! Calorie counting is so over-rated, IMHO, and usually acts as a distraction from focusing on the bigger picture, such as the satiation value, as recently blogged by our esteemed Dr Briffa!
As of today I’m experimenting with “Just Like Sugar” in place of raw cane sugar. This is a completely natural sweetener made primarily from Chicory Root which, unlike some other sweeteners, has been shown to have absolutely zero impact on blood sugar levels. So far so good. I had previously tried some natural Stevia but found the the strong bitter after-taste unbearable - almost as bad as the excitotoxin Aspartame!!
Keep up the excellent work!!
Faz
June 25, 2009 @ 4:35 pm
I have also heard from someone who has experience in this field, being an ex-bulimic herself, that mineral and vitamin deficiencies can also lie at the heart of this problem, with zinc deficiency being one of the main ones. Dr Mary Eades recommends taking zinc and copper for people who suffer from binge eating.
Sally Fallon writes in “Nourishing Traditions” that chocolate cravings can be caused by a magnesium deficiency. I haven’t read anything elsewhere to substantiate this, but I tried the strategy of magnesium supplementation when my eldest daughter, then almost 12 and in the middle of a growth spurt, had a few chocolate episodes (she was “stealing” the left-over Christmas chocolate from a “stash” I had hidden in the cellar, and ate about 2 or 3 whole bars in one week - yikes!). At any rate, I made her take some low-dose magnesium supplements and she then left the chocolate alone.
If I were you, I would look into whether there are actual studies “out there” on the effectiveness of giving zinc and magnesium supplements to people with carb cravings and/or eating disorders.
However, I am not so sure whether I would personally want to try glutamine for cravings, as, to my knowledge, it is related to that wonderful substance, monosodium glutamate, which is said to have pretty nasty effects on the brain.
I’d be curious if you find anything about whether raising somebody’s zinc and magnesium status helps with reducing cravings. Magnesium is said to help with depression, to improve sleep, so it can’t really do any harm to offer it to bulimics: if they are purging often, then they will certainly be regularly depleting their magnesium stores, too.
What do you think about these ideas?
merryweather
June 25, 2009 @ 4:35 pm
I think I should try some magnesium, because I’m a chocaholic.
I’m also an ex-alcoholic and ex-smoker. I used amino acid supplementation to quit smoking. It seemed to help. I’m pretty sure glutamine was part of the regimen. I had been smoking for 30+ years, so yeah, worth a try.
June 25, 2009 @ 7:41 pm
I would just like to add a comment about late afternoon carb cravings. I have been following a sugar-stabilising diet for years and usually have a very low-carb lunch - yesterday it was cauliflower soup thickened with tahini and crab salad with mayonnaise - no bread or starchy vegetables. This doesn’t stop me getting the late afternoon carb cravings. I accept that sandwich lunches will aggravate the problem but cutting them out doesn’t eliminate it.
June 26, 2009 @ 10:03 am
I crave sugar all day long despite following a low GL highish protein diet. I have to eat about every 2 hours or so or I start to feel sick and irritable! I have tried taking chromium and find it makes me a lot worse - I feel sick with hunger half an hour after it. I take magnesium. Doesn’t help. Interested to try the glutamine - is it really linked with MSG as I’m allergic to that…? Keep up the good work, John. I love this site.
June 26, 2009 @ 10:19 am
I am a diet controlled Type 2 diabetic, of about 9 years standing. My self monitoring has been very thorough and my reading and discussions with specialists mainly from NZ and USA, has shown how differently different peole react to the same food stuff.
Alcohol reduces my blood glucose substantially; I get no glucose bounce, most people do. I get massive glucose surge with honey which is expected, but much lower with maple syrup which is not (I consume neither other than establishing my food tollerances)
I find low GI VERY helpful, essential even. GL I find a waste of time as volume consumption varies with each meal. I have a measured my blood for years and have a “map” of GI for my body and note variences with standard charts. I also note my glucose reactions to food types is changing over time.
Finally I would suggest that a major drop in blood glucose also indicates a liver mal-function as is that not the organ that releases glucose reserves into the blood??
June 26, 2009 @ 11:02 am
as a recovered.recovering anoerxic, i can absolutely say that the food that goes in my body plays a HUGE role on how i behave, how i think and how i act. carbohydrates being cut completely from my diet has controlled my eating disorder to a degree i never though imaginable. i can live, eat and not even worry about exercising or food… it is a dream come true for an anorexic to have their blood sugar sound and stable.
June 26, 2009 @ 5:22 pm
merryweather/sugarfiend: Glutamine is the most abundant naturally occurring, non-essential amino acid in the human body, it’s a natural substance found in, for instance beef, chicken, fish, eggs, milk, dairy products, wheat, cabbage,beans and spinach
It’s interesting to look on some of the body building forums re carbs. Body builders have long supported a low carb high protein diet and also have carb cravings. The general feeling is that both chromium polynicotinate and glutamine are helpful in reducing carb cravings. I have been researching (as a lay person) the links between hypertension and insulin resistance and its associated side effects such as midriff fat. Chromium in particular seems to crop up regularly in both cases as does fish oil and CoQ10….. hmmm…. the more I read the more all these things a seem to be so obviously connected and it’s clear that addressing the root cause of conditions such as diabetes, hypertension and obesity is essential if there’s to be any long term success.
June 27, 2009 @ 1:41 am
Margaret,
The reason for your mid-afternoon carb cravings is that your lunch has way too little protein in it. Consume enough protein and, in my experience, it will stop the carb cravings dead in their tracks (and it would, of course, be supplying glutamine).
John,
I saw some research many years ago about the relationship between chromium deficiencies, corresponding deficits in glucose tolerance factor and cardiovascular disease (in terms of the deposition of arterial plaques), which suggests another link between the high carb diet and cvd.
July 1, 2009 @ 11:53 am
Anecdotally I’ve trialled various dietary supplements without any noticeable effects, from which I assume I’m getting enough from dietary sources: they may well work when there’s a deficiency. Having said which I am currently re-trialling magnesium, this time as citrate.
This makes me wonder whether the effect of glutamine is paralleled by sufficient dietary protein. it’s certainly been my experience that hitting myself with boluses of carbs was *not* an effective treatment for reactive hypoglycemia whereas cutting the carbs and upping fats and protein (the latter especially at breakfast) has not only normalised my blood glucose but greatly reduced my hungers. I can currently go for much longer and work harder with little need for snacks by running principally on fats/ketones and deriving most of my glucose requirements from protein, and sufficiently small quantities of low GI carbs that do not spike my blood glucose.
Certainly in this “blame culture” it’s easier to blame the patient rather than pragmatically look at ways to actually reduce the “disease” process. High GI carbs and especially grains hit the dopamine system, but once the cyclic BG/insulin levels are sat on this addictive response seems to disappear
I find it entirely logical that conditions such as bulimia and anorexia are overreactions within the complex endocrine system
July 12, 2009 @ 8:34 pm