While I am a fully licensed physician in Kansas, this communication does not constitute personal medical advice or establish a physician-patient relationship. See your own physician to discuss your particular diagnosis and treatment
CARBOHYDRATE ADDICTION
I feel that carbohydrate addiction is very real and quite prevalent. I inform my patients regarding this, often not recognized, disorder and discuss treatment of this condition. Much of the information below is from Dr. Robert Cywes, bariatric surgeon, also known as “the carbohydrate addiction doc.”
Diabetes mellitus type 2 is caused by a psychological disorder or misinformation, in the case of performance athletes.
Some medications slow down the progression of diabetes mellitus type 2, but do not treat the cause. Medications alter the handling of sugar (glucose) that his present.
Carbohydrates have psychoactive effects. (See PET scan discussion below). Abstinence of less than 30 g of carbohydrates per day is preferred and even required in order to have remission. Carbohydrates are not necessary for survival. Gluconeogenesis and glucagon help you to maintain an appropriate blood glucose level. Carbohydrates are endorphin-releasing drugs not hunger satisfying food. Carbohydrate consumption then, is an emotional consumption, not triggered by hunger or thirst.
Misinformation in athletes also can result in insulin resistance and diabetes mellitus type 2. Carbohydrate intake and loading has been a tenet of feeding athletes for many years. Athletes that switch to low-carb eating are now able to fuel their body with fat consumption. (See Caryn Zinn, nutritionist discussion below).
In Dr. Cywes's practice, he has noticed that patient with diabetes mellitus type 2 often consume 75 to 90% of their total daily calories in the form of carbohydrates. He states that diabetics could have 15-20 consumptive events per day, usually in the form of carbohydrate snacks or drinks. This will match up with daily endorphin activation requirements. When people use carbohydrates as an endorphin activator the unfortunate thing is it does not allow for emotional processing and provide appropriate therapy.
Patients need to replace carbohydrate endorphin stimulation with other endorphin stimulation habits such as exercise, art, music, to name a few.
Unfortunately, relapse like any addiction does occur and needs to be planned for.
Tenets of treatment:
Complete abstinence from carbohydrates (as little as possible)
No calories in drinks
Vegetables are okay, except: potatoes
Avoid rice and grains
Fruit not okay, except: Avocado, olive, tomato, nuts, and seeds
Sequential eating (eating food slowly, sitting down at a table, drinking water) allows leptin (hunger-regulating hormone) to work to prevent overeating
Fast if not hungry
No calorie counting, your body will know what you need
Your body may take 60 to 90 days to become fat adapted. Your body may improve insulin sensitivity during this time, even if you are on insulin and have diabetes mellitus type 1.
To prevent side effects such as rash, kidney stones, gout, and joint inflammation, gradual reduction in carbohydrates over 1 to 3 months. Start with elimination of sugary drinks, then snacks, then grains, then fruits. Increase fat content to protect protein intake.
PET scan discussion
Positron emission tomography (PET) scans measure metabolic activity in the tissue studied. PET scans have been used to reflect brain activity after cocaine use. Interestingly, the same area of the brain stimulated with cocaine use is stimulated with carbohydrate ingestion. This happens to be the dopamine-producing area of the brain. Dopamine is the "feel good" neurotransmitter that we all crave. Dopamine is important in shaping the neural circuitry in the brain. Strong objective evidence for the addictive nature of carbohydrates.
Caryn Zinn, nutritionist discussion
Caryn Zinn has been a nutritionist for 25 years. She has worked with high-performing endurance elite athletes as well. I was introduced to her practice through my educational journey. She is a strong believer in the value of whole foods and low-carb, high-fat eating for all of her clients. She quickly dispels the myth that carbohydrates are necessary for athletic performance. In very lengthy endurance events, she may recommend small amounts of carbohydrates, but not nearly what I expected. The performance of these athletes is inspiring!
I hope this information helps you and your loved ones!
Jason Williams, D.O.