Posts Tagged ‘sugar’

Food & addictions

Thursday, March 18th, 2010

Why do we see ever-increasing problems with food consumed to excesses, to the point of addiction, and serious health issues? How do the functions of the brain impact these obsessions? Should food addiction be included in the new DSM. Dr Inaba shares his views.

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Transcript (edited):
CNS: Recently in the news – Comedian Jeff Garlin was interviewed by “Daily Show” host Jon Stewart, Garlin has a new book out “My Footprint”, a memoir of his longtime food addiction, and a related story out of Canada, talking about food addiction in general. Darryl what are your thoughts on the physiology involved in taste and smell?

DARRYL: Well, it’s surprising that food and specifically food addiction isn’t covered as a major addiction in the DSM 4 (Diagnostic and Statistical Manual of Mental Disorders, 4th edition) or in the proposed DSM 5. It is considered an impulse control disorder, but food certainly fits the bill of how drugs interact physiologically with the body to create craving, create an insatiable need to continue using and certainly some people genetically are going to be more sensitive than other people. There are rats that have been genetically bred to carry a gene that makes them obese. Researchers put those rats next to normie rats (rats without that gene) provide them the same food after they have been weaned and the OB/OB rat becomes totally obese very quickly whereas the other rat stays normal.

CNS: In exactly the same environment.

DARRYL: Same environment same exposure to food. So there is a genetic component. There is also a stress component and all the other factors that we know change the brain in an addict, making them compulsive and/or cause them to crave a drug. Every program I’ve ever worked with provided clients with an understanding of food addiction and the problems food can cause, especially for those addicts who quit nicotine. You quit smoking, what do we see? People gain weight right away. People quit alcohol…tremendous weight gain. People in recovery from heroine crave sugar, Coca-Cola or chocolate first thing in the morning. This occurs because it’s the same process of the brain interacting through the reward/reinforcement circuit that we see with drug addiction. The moment people put high sugar, high fat, caloric food into their mouth, their brain releases endorphins, giving them that burst of pleasure, that sense of fulfilling a need, that they’re doing something good. This drives the brain to want to repeat that experience. We’ve got to remember, food is a basic survival need. If we can’t find food, we would just starve to death.

CNS: So…eat all the time…whenever you come across food.

DARRYL: It’s hardwired into our brain as a basic survival need. When we eat, endorphins are released followed quickly by dopamine which creates that sense of reward and that sense of justification, it’s all directly wired. Scientists believe that the taste buds are wired into…directly into.. the reward/reinforcement circuitry which creates the drive to continue using, continue seeking food. Now, the difference, I guess is as we evolved a neocortex, and we evolved the control circuitry of the brain, we gained the ability to measure the consequences, measure satiation and are able to decide whether we need to keep eating. I guess the difference between a compulsive overeater and someone with a hyper eating disorder is the sense of not getting enough food. People who are normies are able to recognize that they’ve satisfied their need for survival; they don’t want to become obese because they know it is unhealthy so their brain is able to shut off the drive to continue eating. The brains of addicts, on the other hand, don’t function as well and they get stuck on a need to continue to access food. The food industry is complicit in this phenomenon.

CNS: They learned how to sell their product well!

DARRYL: Some add high fructose corn syrup into everything they touch in order to get Americans to be a little bit heavier. It is an instant refine carbohydrate that activates that reward/reinforcement, the endorphin and the dopamine circuitries in that brain that drives people to eat this stuff. And as we’ve seen and just now developing the science of…if you get excessive dopamine than usual, you start to destroy the fibers that connect the control center of the thinking brain to the survival centers of the primal brain. I think Type II diabetes is probably the most prevalent condition in America. I don’t think it is an accident that it’s connected to our fast food, high fat, high sugar diet which immediately activates the addictive center of brain. And “Madison Avenue” has created such strong “branding”, causing an almost unconscious awareness in the brains of citizens in this country. So even if you didn’t want a McDonald’s burger…even if you didn’t like a McDonald’s burger, you couldn’t help but be aware of them.

CNS: And you took yourself directly there!

DARRYL: Research shows that if you expose a message to a listener or viewer 4 times an hour, like a jingle or a visual or auditory queue of a certain drug, it creates a memory protrusion in your brain. You do it 4 to 6 times an hour incessantly day after day and it becomes a permanent reinforced memory protrusion or memory bump that that connects all your emotional memories to other memory bumps all over your body. All of a sudden you pass a McDonald’s, and you drive right in. You’ve just eaten. You’re fine. You don’t need food, but you’re driving in the takeout line and scarfing down a couple of cheeseburgers that you didn’t know you really wanted.

CNS: This is more predominant in our country than in Europe or Third World nations.

DARRYL: I don’t think they’re far behind though, Howard. I believe America is the pacesetter for the rest of the world in terms of quality of life, so to speak. Or what people view….

CNS: Obesity…a positive quality of life?

DARRYL: Well, I think people in Russia…people in Mexico…people in poor parts of the world, anxious to come to America – to shop in a big supermarket…a Costco…

CNS: And they probably still know about McDonald’s over there.

DARRYL: Yes, there is a McDonald’s in every country, along with KFC because those places make money. Corporations know they’ve got a winner and they know how to market it to get into people’s subconscious – so they crave this stuff. We’ve created revolutions in our society, a whole sort of revolution in dieting, revolutions in TV shows, revolutions in reality situations where they are directly addressing people with obesity problems and trying to promote different ways to help them maintain a healthier diet and lose weight. The reality though is…if you think a cocaine relapse is heavy, or a nicotine relapse is terrible, or relapsing to heroine is horrible, check out the relapse rates on diets weight loss. Approximately 95, 96% of the people who consciously decide to maintain a healthier diet…lose weight and reach some their goals and objectives, relapse back into heavy use and gain the weight they lost and then some.

CNS: Well the diet industry, as you point out, has become an industry of its own. In terms of treatment…in the context of drug addiction treatment, what can people do? What should they look for in terms of a way to address their problem?

DARRYL: I think the solution is going to be in medication. I really do. I look at the future in terms of developing non-addicting, non-stimulating medications. The problem to date is looking solely at medications that cause anorexia…that stimulate the brain…so the amphetamines, the Ritalin’s, the things like that, that also produce their own dependence and their own dopamine problems are offered. And they don’t work with weight. People who are put amphetamines, which are not recommended for weight loss anymore, gain tolerance very quickly to the amphetamine and pretty soon…

CNS: Then you’re addicted and you go back to eating.

DARRYL: Right. And they eat more than they did before, even though they’re on amphetamines so, I don’t think those types of medications work. We are learning more about appetite and enzymes and substrates like rimonabant which control appetite. And we’re looking at ways of effectively interfering with appetite so people can lose weight in a more realistic way rather than being stimulated to diminish hunger to lose weight. I was very hopeful about a marijuana antagonist that was being developed – rimonabant. Scientists chemically produced an antagonist or a blocker to marijuana, not because people overdose or experience toxic effects from marijuana, but because one of its biggest side effects is the munchies. People smoke dope and get the munchies, so researchers realized that if they can block the cannabinoids that might be responsible for our own hunger and appetite, they might get the opposite effect and actually decrease appetite. It was looking pretty good, it was on a fast track to be developed as one of the first reliable diet aids, but they found that when they gave rimonabant to a lot of patients…we should have known this…the patients got extremely depressed because the other thing about food is it is an antidote for depression. Food, you know, comfort food is comfort food. If you eat high calorie, high sugar, and high fat food when you’re depressed, you don’t feel as depressed. Food helps deal with stress and it gives that instant reward gratification. There are a lot of factors to consider when dealing with the drive to continue eating or hyper-eating and hopefully we’re going to develop some medical ways to address those things. Diets, self deprivation and starvation and all that other stuff isn’t very effective.

CNS: And the balance, of course, is finding drugs, finding medications that don’t have overwhelming side effects. I’m sure we’ll talk about this more because it is a topic that is critical to life
That wraps our pod for today. Thanks for visiting the CNS Podcast. Please check back soon for the next in the series and visit our website, www.cnsproductions.com .

 
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Children of Alcoholics Week and sweets, depression & alcoholism

Friday, February 19th, 2010

We look at a new study correlating craving sugar, depression and the tendency toward alcoholism in children; also this is the 2nd annual Children of Alcoholics Awareness Week.

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Transcript (edited):

CNS:   Welcome to the CNS Podcast featuring Dr. Darryl Inaba, research director for CNS Productions.

CNS:   Alcohol and depression in children are topics in this week’s news.   It is National Children of Alcoholics week, (February 14 -20, 2010) not just in this country, but around the world and there is a new study that just came out in Addiction Journal (http://www.addictionjournal.org/viewpressrelease.asp?pr=118) looking at the relationship between sweets, depression and the proclivity towards alcoholism.  How do you view this study?

DARRYL:      Well, it’s confirming what we’ve all suspected and actually clinically observed in treating alcoholics and interacting with their families and their children.  I believe the study looked at about 300 or more children, ages 5 to 12 or so, researchers carefully took their histories and they exposed them to different sugar solutions and asked the children which of the solutions they preferred.  The results showed that the children who preferred the sweetest of the solutions, I think it was 24% sucrose, which is equivalent to about 14 teaspoons of sugar in 8 ounces of water,  I think that is about double the amount of sugar there is in Coca-Cola, so that’s really, really sweet.

CNS:   And Cola’s are plenty sweet.

DARRYL:      Absolutely, and the children who preferred that level of sweetness had parents who were alcoholic and/or depressed and the children were also exhibiting depression.  So the conclusion from this study implies a need within children who may be predisposed towards alcoholism and depression to crave high amounts of sugar which creates the dopamine effect in the brain or in the reward reinforcement center that sends the message that a basic need is being fulfilled. Researchers believe this preference for more sugar is a need to stimulate that center to a higher level than normal. These children need a lot more dopamine released in their brains in order to appreciate it.  They are postulating that these kids need a lot more sugar, but get a weaker effect or get a weaker satisfaction from it.  That’s a prelude to alcoholism.  They’re not saying it actually predicts that the children are going to be alcoholics, but we do observe when alcoholics come into treatment, residential treatment is where we really see it, they really prefer sugar when they first come into treatment.  And they crave sugar any place they can get it…candy bars, whatever.

CNS:   Right, of course the alcohol breaks down into sugar.

DARRYL:      Right and they have, I guess, a greater need for more.  Even though they’re taking in a lot more it’s not satisfying them.  So…it is a common thing for the alcoholic, the heroine addict too, is first thing in the morning they reach for a  Jolt or a Coca Cola or something with a lot of caffeine and a lot of sugar in addition to their drug.  So there is, I think, a clinical correlation to this craving for sugar or need for more sugar that may be greater in those who are predisposed to or ill with the condition of alcoholism and addiction.

CNS:   Sounds like a bunch of double whammies, all on top of each other.  If you have sugar proclivity, #1 that’s going to inch you towards being overweight and obese and if you are one of those likely to become an alcoholic, then the alcohol turns back into glucose.

DARRYL:      This also speaks to the fact that there is an epidemic of metabolic disorder in the United States.  The tendency toward Type II diabetes is just horrendous.  I think the last report, indicated maybe a good third of the country or close to 30% of the population had either a diagnosisable Type II diabetic condition or are pre-Type II diabetic.  I don’t think that number is duplicated any place else in the world.  Something is certainly changing in our society in terms of the way we handle food and sugars and in turn, how we are dealing with the problems of addiction.

CNS:   Large scale processed food, fast food, is of our generation.  I remember when I was a kid, we lived right down the street from the first McDonalds, and there didn’t used to be so many.  We’re now seeing this profound shift in metabolic diseases.

DARRYL:      Well, I’ve become a compulsive label reader now.  I don’t buy anything without looking at calories, carbs, fiber, sodium and all the different fats. It is just shocking to see what is in our processed foods.  I heard someone saying that the best thing for you diet if you have Type II diabetes, is to stay away from anything that is in a box, a can or bottle.  And from what I’ve read and what I’ve seen that is basically true.  If we hearken back to when we were kids, most of our foods were prepared by our mothers from scratch – fresh vegetables, fresh fruits and fresh ingredients and then cooking them up.  But now…it’s pretty much the norm -even when cooking at home ..you’re cooking out of a box, a can or a bottle.  If there is this link with sugar and the link to the processes in the parts of the brain that reward center in the adult receptor sites and what we call the nucleus accumbens septi_ and if that’s all increasing, we’re also going to be looking at an increase in addiction and in the numbers of people per capita that are affected by alcoholism and other drug addictions.

CNS:   Those numbers have stayed relatively steady, have they not?

DARRYL:      They’ve been fairly steady.  We don’t have a good way of confirming them though.  I mean people usually conceal their addictions.  They don’t come forward with them.  They don’t answer questions honestly when we do a pre-screening for hospitals or medical health care…we still rely on the person telling us the truth when we ask them how much they drink, or if they have taken any drugs. Most people know how to avoid answering that question, so we don’t really know. All we have is based upon the percentage of people who are honest with us so perhaps we are just measuring honesty in America, not the actual incidence of alcoholism and drug addiction.

CNS:   Alcohol use is probably under reported because it is so much a part of society and it is more accepted than taking drugs. A study in England reported that alcohol use in that country is severely under reported.  If a social worker goes into a house for some reason, they make no note of obvious alcohol use, whereas if there is any evidence of blatant drug use, that is immediate cause for intervention or drastic steps.

DARRYL:      Yes, for removing the children and that’s a sad situation because it fails to recognize the impact that alcoholism has on children in an alcoholic family.  We have known for a long time, thanks to authors like Claudia Black, Rachelle Learner – and others, how parents’ use of alcohol, really impacts their children for a lifetime in extremely negative ways.  The national children of alcoholic’s week, now in its second year, brings attention to that. I’m glad to see it happen because it has been noted in the treatment community for as long as I’ve been in the field.  Alcoholism is selfish, and I’ve always used that when we do family therapy. Someone with an alcohol problem looks at themselves and they may feel guilt, and shame and they may feel concern about some of the personal consequences that their behavior brought about, but they fail to look at the consequences that their drinking had on the people who love them – their spouses their children and their families.  We’ve noted that the children of alcoholics, in order to deal with the uncontrolled drinking of their father or mother, develop very specific personality types that stay with them throughout their life and make it difficult for them to engage in relationships and to have an appreciation for life.  Oftentimes the oldest child is what we call the “model child” – they see so much dysfunction going on, they care for their siblings, and take on the role of the parents.  They kind of overdo the “goodie” role and cook for the parents, make teacher’s appointments for the parents and just take care of all the siblings and grow up with such a fear of drinking that they remain sober.  They don’t even experiment because they’re afraid of the process.  And then there is the “problem child who at an early age starts drinking, using drugs, starts to act out in delinquent ways, causes problems at school and is just a problem.  Alcoholic parents pay so much attention to drinking, that the kids get very little attention and one of the ways to get attention is to be a problem.  Because if you’re a problem – even though it’s negative attention – you get slapped or yelled at or…you get put down…you get time outs… you get all these punishments from parents, but its attention anyway and you’re getting your parents to interact with you.  Another personality type that has well been documented is the space case – this is the child who deals with the dysfunction in the family by ignoring the elephant in the living room.  They tune out of everything – they will step over their father on the way to school without even noticing they’re stepping over a drunken father; will not mention their parents and ignore them when they’re in a drunken state. They become totally spacey and detached from all things around them for the rest of their lives. Another way some kids deal with alcoholism is to become the family clown.  This child learns that humor seems to gloss over every single problem in the family.  So he or she learns to use humor inappropriately.  Everything becomes a joke and everything is humor.  But those are classic characteristics of children of alcoholic parents, documented by a number of authors.  The British noted that in America children of alcoholics are often abused in much higher percentages than children coming from parents who are not drinkers and children of addicts and alcoholics are 4 to 5 times more likely to develop those problems in their adult life than are children from non-alcoholics.

CNS:   Which is something like 1 in 20 people?

DARRYL:      Right.  There are also higher rates of assault and other criminal situations amoung addicts and alcoholics and that exposes their children to a lot more damage.  So basically, it is a well-known and well-documented fact that children of alcoholics are going to suffer tremendously…tremendous consequences from the act of their parents drinking and drugging and yet, as you mentioned at the start of this, our society and our social systems seems to pay less attention to alcohol than to other addictions. Case workers go into a home and see a parent actually involved with domestic violence, which is frequent in alcoholism, and they take the kids because of domestic violence, not alcoholism.  They see the parents smoking marijuana, they take the kids – but if the parents are drinking, it’s not a major alarm, in and of itself.

CNS:   Because it’s so ubiquitous in society and it’s legal.

DARRYL:      I think society has failed to realize that drinking and being an alcoholic has tremendous consequence on children. We tend to focus on the catastrophic consequences affecting the individual, how their lives are falling apart and the need to treat them that we forget that their behavior is impacting their families in a horrible way.  We can see that by looking into family health records once an alcoholic is identified.  It turns out that the families of alcoholics greatly overuse their health insurance and health benefits compared to families of non-alcoholics.   We can see the horrendous impact of alcoholism extending beyond the active drinker, onto their families who may or may not be drinking.

CNS:   The most important thing to do is to pay attention to this.  Pay attention to the family around you…to the people around you and…not just bury our heads.

DARRYL:      Well, that’s the good thing about this (Children of Alcoholics Week).  Although these issues have been around for as long as I’ve been in the business here and treating addicts and alcoholics for over 40 years, it’s sort of a tragedy that this is only the second year of a national awareness campaign…national awareness week, but I’m glad it’s happening.  So now some people may pay more attention to it and we may be able to generate resources.  There are Al-anon groups for families of addicts and alcoholics.  In good treatment programs and every program I’ve been involved with, we insist that families get some sort of family therapy.  Usually on weekends family members may be working or going to school, so on weekends we want the whole family to come in to learn about this condition, learn about how they are impacted by this condition and learn the resources available to help them regain a normal quality of life rather than having to continue to suffer from the effects of somebody’s alcoholism.

CNS:   We would love to hear comments on this topic or any others, so please do, if you have a comment or question, stop by our website and leave us a note or ask a question.  The website is cnsproductions.com.  And we will talk more about these and related issues in the weeks to come.

 
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