Does lockdown make you wonder if you might have a problem with food? Do you find yourself craving sugar or bingeing on snacks or treats, especially at nighttime? This is exacerbated by the fact that we are all home (ALL the time), and all that tasty food is right there for the taking. There are several steps you can take to identify or overcome emotional eating. The first and most important thing is to determine what causes your food cravings. Determining the cause will help you discover whether or not you have a food addiction or if there is another potential cause for your food cravings.

How to Determine what triggers your cravings

Check in with your intakes 

Most of the time, cravings are a response to a need for fuel. Many of my clients get cravings in the evenings, especially for sweets or salty snacks, because they are undereating either carbohydrates or calories throughout the day. More than half of my clients who are trying to lose weight are actually undereating, so honestly assess the possibility that you might be over-restricting. Common symptoms include low energy, poor sleep (or sleeping too much), brain fog, fatigue, memory issues, anxiety, emotional dysregulation/moodiness, and food cravings (especially cravings for carbohydrates or sugar). There’s nothing wrong with eating those foods, by the way, but we want to be in a place of intentionally choosing to eat them because we will enjoy them, not feeling compelled to eat them because your body is just so. Dang. Hungry!

If you aren’t sure (most of my clients assume they need to eat less than they actually should), find a Registered Dietitian to help you know how much you should actually eat. I’m still offering video appointments during the lockdown! Most adult clients should be eating more than 1400 calories and well over 100 grams of carbohydrate daily (even if you’re trying to lose weight or if you have diabetes). Calorie tracking apps and online calculators are often inaccurate.

Assess your emotions

If you are certain you are meeting your body’s needs and you still struggle with a compulsion to eat unhealthful foods on a regular basis, try looking at your emotions. The second most common cause of food cravings has to do with dopamine, a neurotransmitter in the brain that makes us feel content. Negative emotions are usually paired with low dopamine. The brain sees low dopamine as a problem that needs to be fixed and will often go hunting for a way to raise it. Eating delicious food is a quick way to get a rush of dopamine. So, often our brains will go straight to the fridge to fix the problem! Your brain doesn’t care if you eat ice cream, it only wants dopamine.

1. Ask yourself if you are experiencing a negative emotion. Boredom, loneliness, stress, anxiety, and depression are common culprits.
2. If the answer is yes, the first line of attack is to try to raise dopamine in a way that doesn’t involve food. You can do this by turning to an activity that you truly enjoy. Calling a friend, doing a crossword, going for a walk, or reading a book are examples of activities my clients have used. The key is that you enjoy it – otherwise it doesn’t raise your dopamine!
3. Sometimes you don’t have the time to do an alternative activity, so the next line of attack is to try to find a healthier food option. Craving salty snacks? Go for a couple handfuls of tortilla chips with salsa,  pretzels, or whole grain chips or crackers (Sun Chips and Triscuits are great options). Sweet tooth calling out to you? Try frozen grapes,  graham crackers, or berries with vanilla yogurt or whipped topping. Finally, if you know that a healthier activity or alternative will not do the trick, it’s not a failure.
4. Try to moderate the amount of a craved food that you eat. Three to four bites of a desired food can cause the peak amount of dopamine response within the following 10-15 minutes. The take-home message? Rather than eat continually until your dopamine peaks and you feel better, try to savor that tasty food for 3-4 bites then wait 10-15 minutes. After that, reassess to see if you still feel like you need more.
5. If you are certain that you really want the food you’re craving, go for it! It is not a failure to eat food you love. Do not feel bad about it! Food is meant to be enjoyed. The most important thing is that you choose to eat intentionally and not because you are underfueled or you feel out of control.

Seek an outside opinion

If you have evaluated the above topics and are still struggling to get to the root of your food cravings, it could be possible that you have a food addiction. Evaluation for food addiction is still in its early stages. Researchers from Yale University have created a food addiction scale but the scoring system is complex and it is not widely used. For now, the best method is to meet with a Registered Dietitian and a Licensed Mental Health Counselor. Since food addiction by nature is a crossover between mental health and food habits, each professional can have a valuable perspective. If it turns out that you do have addictive food behaviors, a holistic treatment plan will involve them both as well.

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How to Make Healthy Changes that Actually Stick

Oftentimes I will have patients with diabetes whose blood sugars are high, and they think, logically, that if they eat very few (or no) carbohydrates, that will help. Unfortunately, they are working against themselves, and here’s why:

The body has what I like to refer to as a savings account of glucose in the liver. When the cells in the body aren’t getting the glucose they need for energy (like when someone skips a meal or when their cells are resistant to insulin), they start complaining all over the body trying to get someone to fix their problem. Word gets to the liver that the cells are starving and he wants to help. The trouble is, liver is a busy guy. He’s got many, many jobs. I often joke that managing this savings account is his “side gig.” He’s not particularly good at it.

In people with diabetes, liver sometimes starts dumping glucose from his savings account into the blood when he doesn’t really need to, and then once he has started…he doesn’t know when to stop. He just keeps pouring and pouring sugar into the blood and before you know it, this poor person who is trying their darnedest to avoid eating carbs in order to get their blood sugars down has a sky-high blood sugar because they haven’t eaten!

It’s the most frustrating thing in the world because it’s totally backwards to what we would naturally think.

Moral of the story: don’t skip meals, and don’t over-restrict carbohydrates! It’s just as important to eat enough as it is to not eat too much to manage blood sugars in diabetes (side note: that’s true for weight loss as well!).

Bonus sub-moral of the story: If you have something frustrating going on with your blood sugars or your weight that you can’t explain, seek out a Registered Dietitian or a Certified Diabetes Educator to help explain all the funky things that your body might be doing without your realizing it! You don’t have to be frustrated and helpless. You can be empowered to better understand your body!

I gotta tell ya folks, sticking to the diabetes recommendations is exhausting, especially when life gets busy. With Halloween festivities and a rapidly filling schedule I’ve found it tougher to stick with the recommendations this week.

I did overdo my official dinner carb budget on Halloween, but I did it in a planned and intentional way. I spread my carbs out throughout the evening and only exceeded my carb budget by 15 grams. And that’s okay. It’s another case against the “diet mindset”: the recommendations are not hard and fast rules and it’s ultimately your life – you get to decide when to push on the guardrails, how often, and how far. The results are yours to own.

It’s going to be particularly tough this upcoming week, as I’m adding in goals to move for 3 minutes for every 30 minutes of sitting, check blood sugars daily, give myself a syringe poke daily (to simulate an insulin injection), and take a daily vitamin (to simulate taking oral medication for diabetes). It is definitely feeling a bit daunting, and I am only committed to this for another week!

The mental and emotional burden of managing diabetes is very, very real and goes far beyond what I’m facing here. When I don’t meet the recommendations, my body compensates and I chalk it up as a “Whoopsie, I’ll do better next time.” While that mindset applies for someone who has diabetes, they have the additional awareness that ongoing “whoopsies” can really do them harm.

For all those with diabetes, I salute you. Your road is not an easy one to walk. The obstacles and struggles on your journey can lead to diabetes burnout , which happens to everyone with diabetes from time to time.

 If you do feel lost, overwhelmed, or depressed (people with diabetes are more likely to be depressed, and depression worsens control of diabetes), please seek out some support and resources. A great care team, support group, dietitian, or even resources at www.diabetes.org can really help bolster your spirit and help you navigate all those tough barriers. You are not alone!

As I’ve been focusing on carbohydrates in my research thus far, I wanted to build a “foundation of physiology”, if you will, to build all the dietary recommendations on. If you’re a science geek, I hope you’ll enjoy this with me. If you’re not a science geek and you’d rather mow grass with fingernail clippers than read about the way your body works, stop reading and come back tomorrow. I promise to post a delicious new recipe for you then. Now, on to the nitty-gritty.

Carbohydrates are the primary source of energy in grains, fruits, dairy, starchy veggies (potatoes, beans, etc.), and sugar. Depending on the type of food, the carbohydrates are either long chains of molecules (complex carbohydrates), or short chains or single molecules (simple carbohydrates). Once you put these in your mouth, your body gets right to work. An enzyme in your saliva starts breaking the bonds between the molecules. It usually doesn’t get very far, because most of us swallow before it has a chance to break all of the chains apart. My sixth grade science teacher used a neat trick to demonstrate this breakdown by giving us each a saltine cracker and told us to chew on it for at least a minute. Eventually, it started to taste sweet because the carbohydrates were being broken down into their individual sugar bits…pretty neat, huh?

Anyway, then you swallow and the food goes into your stomach. Not much happens here in the way of breaking apart the carb chains, because your stomach contents are too acidic for the enzymes to work. After your stomach has done its thing, the food passes into your small intestine where most of the magic happens. Another enzyme (dispatched from your pancreas) goes to work breaking the rest of the bonds in the chains of carbohydrates. You are basically left with single molecules known as monosaccharides. You may be familiar with their individual names: glucose, fructose, and galactose. I’m only going to talk about glucose for now, because that’s the most prominent player in your energy pathways. Glucose molecules are transported into your intestinal cells and then pass from there into your blood through a variety of methods. If you have ever heard of someone testing their blood glucose or their blood sugars, they are essentially measuring how many of these glucose molecules are floating around in their blood at any given time. Some of the glucose then goes to the liver for storage, and some of it needs to get into your body’s cells to provide you with energy. To get out of the blood and into most of those cells, glucose needs help from a hormone called insulin.

Think of the glucose molecules in your blood as people walking on the street, and the cells of your body as locked houses. The glucose can’t get into the houses without a key – in this case, insulin (as you can see in my highly sophisticated diagram above). Once it’s in your cells, it can either be used to make energy right away, or stored away in long chains called glycogen until your body needs energy later.

If there is more glucose left over when all of your body’s glycogen stores are full, then your body converts the glucose into fatty acids and stores it away as body fat. Furthermore, that extra glucose actually tells your body to use less of your body’s stored fat for energy. Now before you go scolding your body for this process, remember that it came from the survival instincts of our ancestors who often lived in times of either feast or famine. While there was plenty to eat, their bodies stored fat to sustain them in times of hunger. The problem for many modern-day people is that they constantly live in times of plenty. When people go on low-calorie weight-loss diets, their bodies will start to use that fat (and unfortunately, muscle) to fuel them. Now I’m definitely not advocating that we all just run off and haphazardly quit eating carbohydrates to lose weight. There are definitely pros and cons to be weighed, and for now I’m an advocate of age-old moderation. In agreement with the information I referenced in previous posts, my textbook on metabolism states that (as of 2009) researchers have yet to determine the ideal balance between carbohydrate, fat, and protein intakes for fat loss. Clearly, there is a balance to be achieved.

So there you have it – a snippet of your body’s complex innerworkings. Maybe now you and your body will have more to talk about!

You may or may not know that energy provided through our diets (measured in calories) comes primarily from three different substances called macronutrients. If you’re not sure what they are, I’ll give you a hint – check the post title! Carbs and proteins each provide 4 calories per gram and fats provide 9 calories per gram. I mentioned on Monday that the MyPlate diet was leaning me in a more carb-a-licious direction than I’m used to. Left to my own devices, I tend to focus more on protein in my diet. For healthy adults, the Dietary Guidelines recommend that 45-65% of our calories come from carbohydrate, 10-35% from protein, and 20-35% from fats. Here’s an analysis of what I ate Monday and Tuesday on the MyPlate diet meal plan:

My fat intake for yesterday crept up because I chose to use my discretionary calories on cookie dough ice cream (yum!), but you can see that I’m still within the ranges for everything based on the plan. That’s all well and good, but where do these percentages come from?

An excellent question. The ranges are based on the Dietary Reference Intakes (formerly known as the Recommended Dietary Allowances) created by the Institute of Medicine. The process for creating these is similar to that for creating the Dietary Guidelines: experts, committees, research, deliberation, gigantic reports, and finally, the guidelines themselves. The guidelines represent what the experts have determined to be a safe, healthful, and adequate intake of any given nutrient. Each macronutrient plays a different role in the body.

• Carbohydrates are anything that can be broken down into sugar in the body. Most of that sugar ends up in the form of glucose, which is processed to create energy.
• Proteins are often referred to as “building blocks”. They make up the cells of the body and act as transmitters and transporters. If dietary carbohydrates are restricted, they can also be used for energy.
• Fats provide a concentrated form of energy as well as components of hormones and other vital goodies. They also provide a medium for delivering fat-soluble vitamins to our tissues.

Since it is the first thing I noticed about my newly-adopted menu (and for the sake of not deluding myself to think you’d read 10,000 words on macronutrients), I am looking into the carbohydrate recommendations first. According to a report by the Institute of Medicine, the recommendations for carbohydrates are a range between the minimum amount of carbohydrate needed to provide fuel for the brain and maintain weight and a maximum recommended amount to prevent weight gain and decrease risk of chronic disease. It goes without saying that obesity and the loads of diseases associated with it are a significant problem in our country, so I looked further into the weight aspect of the recommendation.

We have all heard of low-fat, low-carb, or high-protein diets being promoted for weight loss. Just for context, the “low” and “high” qualifiers here are in reference to intakes that are outside of the recommended ranges I mentioned earlier. In the Dietary Guidelines 2010 Report, the authors wrote that “no optimal macronutrient proportion was identified for enhancing weight loss or weight maintenance” and that “there is strong and consistent evidence that when calorie intake is controlled, macronutrient proportion of the diet is not related to losing weight.” Two paragraphs later, however, they reported that twenty research studies showed no difference in macronutrient proportion for weight loss, thirteen showed that low-carbohydrate diets were more effective than either high-carbohydrate or low-fat diets, and six showed that high-protein diets were more effective than low-protein diets. So you might be having the same issue I am here – what is strong and consistent about the evidence? Nearly HALF of the total studies included are in disagreement with the conclusion. Now granted, not all research studies are created equally. The DGAC has a scoring system that rates the impact of the study based on the quality of the research, which may have led certain studies to be considered more relevant than others. Still though, I’ll have to look into the research articles myself a little more to see how it all really pans out.

In other news, I begin my traveling tomorrow to visit my friend Abbie in Lake Tahoe for a weekend snowboarding excursion. As I will be continuing my diet through the trip I informed her ahead of time of my situation. Fortunately, Abbie is an excellent sport and fully supportive of my diet plans. Thus, I will actually be flying all of my groceries to Lake Tahoe with me (thank goodness Southwest allows a free checked bag). I am sure at some point that I will end up straying from the meal plan, but I will still aim to eat MyPlate meals and meet my calorie goals each day. After all, adaptability is an essential life skill, is it not?