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
