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

I’m back with more Trim Healthy Mama posts! I’ve been in blogging limbo for the last couple of weeks because I’m working on moving my practice into a new office! It’s so exciting – check out the new space!

Anyway, that’s not why you’re here, is it? You’re here to find out whether or not Trim Healthy Mama is a good option for your life! Overall, the premise of the Trim Healthy Mama Plan is sound enough that if you want to lose weight, it will probably work. The benefit of THM is that it does a better job of switching from weight loss to maintenance than many other diets. It takes a unique approach and the authors provide several options for customization.

Like anything, eating plans are never one-size-fits-all. Some people will love the THM plan and others will struggle to follow it. After researching the plan and following it myself, I’ve put together some tips to help you decide if you are likely to be successful with THM.

You are likely to thrive on Trim Healthy Mama if…

 You are satisfied after eating low-carb meals (particularly if your goal is weight loss)

For some, grilled chicken on a large salad with dressing is a full meal. Others will still be asking for some fruit or a roll after they’re done. This is partly related to blood sugar regulation, partly to personal preference, and it’s very individual. If a steak and some roasted veggies sounds like all you need to be happy, you’ll do just fine in this area.

You aren’t a “social eater”

Social eaters get a large chunk of their enjoyment from food by sharing it with others (going to others’ houses, going to restaurants/parties, sharing meals, etc). Plans like THM that have a lot of “off limits” foods make this tricky unless you’re socializing with other people who are following the same plan. If you could care less about snacks at parties or don’t mind bringing your own thing, you’re good to go.

You like to cook/bake OR you don’t mind eating the same things from day to day

According to the THM authors, you don’t necessarily have to cook to follow the plan. After following it myself, I would say that’s true, but your options will be much more limited if you don’t.

You need a little guidance for moderation

If hearing the word “moderation” makes your eyes glaze, or if moderation just seems to be a nebulus concept, it may help you to have a structure like THM to guide you.

You’re interested in nutrition

This isn’t a must, but having an interest in the way the body works and how it interacts with food is helpful in understanding the plan. I haven’t even mentioned all of the supplementation or “add-in” recommendations the authors give in the book for boosting nutrition, but they are pretty in-depth. Some nutritional background or curiosity would be helpful for working through some of those more scientific chapters.

You might want to choose a different plan if…

You or your family have dietary restrictions different than those on the Trim Healthy Mama Plan

The THM plan is already more restrictive than is necessary to achieve most health goals, so if you’ve got other restrictions going on, this is going to make everything tougher. My philosophy is always to find the least restrictive way to head where you’re trying to go. Don’t make it harder on yourself than is necessary!

Being told you can’t have something makes you want it even more

There are quite a few “normal” foods that are not allowed on the THM plan, so if having those parameters makes you start jonesing for ice cream or a baked potato, this probably isn’t the plan for you.

You love baked goods

I’ve heard (and continue to hear) that there are tasty grain-free, sugar-free baked goods out there. I certainly won’t claim to have tried them all. In fact, I recently heard from a couple of experienced THM followers that the best results come not from any one wheat flour alternative but a blend of several. Regardless, baked goods were my biggest struggle following the plan (and I’m not a bakery junkie). I’m sure continued experimentation would yield better results than I achieved, but I’m pretty certain that even the best grain-free options aren’t going to equal the real deal. If baked goods are something you absolutely love, losing that aspect of your food quality of life would make following THM tough.

You dislike “diet lingo”

If learning a new system of numbers or language to track your health goals is not up your alley, this may or may not be for you. As with some other diets out there, Trim Healthy Mama has a language of its own – S meals, E meals, crossovers, S helpers, and fuel pulls are all part of the lingo in this case. For some people, learning these will be simple, make sense, and not be a problem, others just won’t want to mess with it. You know who you are!

So there you have it – a few tips to help you know if the Trim Healthy Mama Plan might be a good fit for you. It’s certainly not foolproof, but I want to acknowledge that every single person is different, and every approach to health and wellness is personal – it has to work for you and not against you.

I want to add a caveat here that I do have some concerns about a couple of the nutritional aspects of the Trim Healthy Mama Plan – not the entire framework itself, but some tweaks I would recommend to anyone who chooses to follow it to ensure they are making the most healthful choices for their lives. Those are coming in a future post, so stay tuned!

Depending on who you ask, you might find anti-inflammatory recommendations that encourage complete elimination of sugar and carbohydrates to decrease inflammation. As is frequently the case, though, those recommendations are likely unnecessary extremes and everything is case-by-case. For one thing, you can probably achieve the anti-inflammatory benefits you’re looking for while still including well chosen, nutrient dense complex carbohydrates. Secondly, why over-restrict if we can still enjoy some tasty treats in moderation? That’s how we balance meeting health goals and living a life we love! So what does the research actually say about carbs and inflammation?

Multiple studies have linked consumption of concentrated sugar and simple carbohydrate consumption with increased levels of inflammation.^1-2 A long time ago I talked in this post about what happens when we eat carbs and how we break them down into blood sugar to use as fuel. Those fuels are stuck in the blood until insulin comes around to let them in to our cells. High blood sugars, especially over the long term, correlate with inflammation in several types of tissue in the body, including fat cells.³

A strong link has been drawn between chronic inflammation and insulin resistance.⁴ This is a vicious cycle because (as you may remember from this post) insulin resistance means that blood sugars get stuck in the blood without a way out, causing fat storage and inflammation. Stored fat then produces inflammatory factors which make insulin resistance worse! Not fair.

So what can we do about it? Well, we can aim to cut inflammation off at the pass by changing parts of our lifestyle and the foods we eat to combat inflammation and give our cells a helping hand with that blood sugar. With regard to carbohydrates, we can do a couple of things specifically:

1. Focus on eating more complex carbohydrates than simple carbohydrates like sugar. What does that mean? Well, complex carbohydrates are long chains of sugars that take much longer to digest, break down, and enter our blood, thus making our blood sugar much more stable (and preventing inflammation from blood sugar spikes). Simple carbohydrates are individual sugars or tiny chains of sugars that break down very quickly and enter the blood rapidly, causing a sharp spike in blood sugar that is inflammatory. Complex carbohydrates like whole grains, beans, and vegetables are connected with lower levels of inflammation.⁵ Same goes for high-fiber carbohydrates like fruit.

2. Avoid eating too much carbohydrate at once. Just like with diabetes, the key to preventing carbohydrate-induced inflammation is keeping the blood sugar from going too high. Eating controlled amounts of carbohydrate throughout the day can help keep your energy up and your inflammation down.

1. http://ajcn.nutrition.org/content/94/2/479.short
2. https://www.hindawi.com/journals/mi/2013/509502/abs/
3. http://www.jbc.org/content/280/6/4617.short
4. https://www.jci.org/articles/view/19451
5. https://www.ncbi.nlm.nih.gov/pubmed/17391554

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 wrapped up carb counting yesterday, and I would be lying if I said I wasn’t relieved that I don’t have to poke my fingers anymore. I’m glad I did it – I got some good ideas for tips on how to make it hurt less (the side of the finger is the spot!). I did miss my insulin one day – I was on an overnight girls’ trip and thought I brought everything (got my meter, lancets, blood sugar log, and vitamin) but I somehow managed to leave my syringe behind. Phooey. There goes my perfect record.

As far as carb counting goes, it’s not awful. It gets tiresome and Halloween was definitely tough, but it wasn’t the hardest part. Getting the 30 minutes of activity 5 days per week was a challenge, but not the end of the world. Now, getting the 3 minutes of activity per every 30 of sitting – that was the sticker. Fortunately, the apps I discussed in this post made it easier. I’ll be writing a post reviewing the two apps soon! Even with the apps, it was downright impossible to do that every single thirty minutes. You know, I have 60-minute appointments and on girls’ day I drove for two hours there and two hours back. No exercise there. But I did the best I could and honestly, it really felt good to get up and get the blood flowing and joints moving on a regular basis.

As a special treat, my husband and I completed the #DiabetesDanceDare for Diabetes Awareness. Enjoy!

For me, snacks are key to carb counting survival. In general, I feel satisfied after eating a carb-controlled meal but I’m finding myself hungry 2-3 hours after the meal. Snack time!

Ideally, a carb-controlled snack for my plan would have 15-20 grams carbohydrate and some protein (even better if it adds in fiber too!). The carbohydrates keep my energy up while protein helps keep the carbohydrates from raising blood sugar too quickly. My struggle is I’m finding the protein portion tough for some reason.

Some of my favorite example snacks include:

• 6-8 whole grain crackers with cheese
• ¼ cup unsalted nuts with 2 Tablespoons dried fruit
• 1 small apple with 2 Tbsp peanut or almond butter
• 3 cups popcorn with a drizzle of olive oil, dash of salt, and garlic powder, rosemary, and thyme (it’s delicious – and even though this one doesn’t have much protein, it’s a whole grain, it’s high in fiber, and the portion is no joke)

My challenge is that often snack time ends up being on my breaks at work, and proteins are either tough to pack or they need preparation and/or refrigeration. I did a stint with mozzarella cheese sticks and they worked out really well but I got a little bored with them. I haven’t been able to make it to Winco to get the bulk mixed nuts at a decent price (I refuse to pay the prices at most grocery stores), and I’ll be honest, I’ve been too lazy to get a little container to put peanut or almond butter in. I could hard boil a bunch of eggs to have ready and take with me, but here again – too lazy, too busy. Gah.

Many times this last week, my snack has ended up being 15-20 grams carb only, without the protein. That’s less than ideal because besides regulating blood sugar, protein helps a snack be more satisfying for longer.

As I gradually add in diabetes recommendations to follow, I have to say that there is a LOT to it. I hear that from my patients all the time, and they aren’t kidding. Remembering to pack a lunch is pretty much habit, but the snacks are often a last-minute afterthought and making sure there’s protein with them seems like a nice idea that only happens when the planets align just right.

Anyway, this is all good experience for me as an RD and it backs up what I hope I communicate to my patients: do the best you can, take one step at a time, and be prepared that life is going to push you back. Life happens. Life gets crazy. Motivation comes and goes. Just be steady and do your best. After all, your life is worth fighting for!