Low Carbohydrates Lead to Big Cravings

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I sat around the table at a restaurant with several other parents. Sometimes when I go out, I like to pose as an insurance agent so that I can really have a break from my work, but this group knew that I was a nutritionist. My colleagues in nutrition often commiserate about being stalked in the grocery store. Someone even followed one of my dietitian friends around a buffet table, saying that she was going to take exactly what my friend was putting on her plate (as if we nutritionists somehow have the answers to what all bodies should have to eat at any given moment!). Well, all eyes were on me at the restaurant as I ordered the seasonal root vegetable stew and enjoyed a homemade roll. Every other person at the table ordered a salad with some sort of meat and didn’t touch the bread. I saw more than one person look longingly at my plate and felt sad for them.

I remembered the time, early in my career, when everyone was so afraid of the fat in foods. I’m dating myself when I talk about Snackwells Cookies, where the fat (and taste) was taken out and replaced by more sugar. Those cookies would probably not sell today because, collectively, we are more afraid of carbohydrates than fats this decade. I have an old handout from the 90s about the reasons why fat is essential in the diet; it sits in my file cabinet like a relic of nutritional history. Today, the number one food component that my clients are avoiding is carbohydrate.

While I’m delighted that we are not starving our brains of fats any more, I’m equally disturbed by the elimination of yet another macronutrient. Macronutrients in foods include carbohydrates, proteins, fats, and water. These differ from food’s micronutrients -- the vitamins, minerals, and other phytochemicals -- that we hear about so frequently as having health-giving properties. Carbohydrates, proteins, and fats contain calories, units of energy that are the true fuel that our body can use for everything that it does. If macronutrients (carbs, proteins, and fats) are our gasoline, then micronutrients (vitamins and minerals) are the spark plugs -- important to make sure the engine runs smoothly, but not the major fuel source.

The body needs a certain amount of carbohydrates, proteins, and fats in order to function optimally, and there is some debate as to just how much we need of each. In my experience -- and I have 15+ years of nutrition counseling behind this -- taking in too much or too little of any food component causes problems. Too little fat makes us preoccupied with food and contributes to reproductive system decline. Too little protein makes us tired, weak, and hungry constantly. And, because this is a post about carbohydrate avoidance, I’m going to spend a little more time on this one...

When a client comes to me and complains about intermittent binge eating or over-eating at night, there is often an emotional or stress-related trigger. But, along with this, there is frequently a diet that is too low in carbohydrates. The cravings for high-sugar, high-starch foods (the cookies and chips and other baked goods) that accompany the compulsive eating are often encouraged by the fact that the client is not eating enough grain-based foods during the day. This is particularly easy to do with  low-carb, gluten-free eating trends today, as restaurants are trying to accommodate consumers’ desires to eat less carbohydrates.

"Aren’t we eating too many carbs, though?" many clients ask. It’s not good to eat up the whole bread basket before eating a meal, right? Of course. Moderation, while not a very sexy term in the nutritional lexicon, is always advised with any eating. In fact, if one tunes in and eats mindfully, moderation is what will keep coming up. The public health message that we need to decrease our carbohydrate intake comes from the fact that, in America, our muffins are gigantic, our intake of sugary soda is excessive, and the super-sizing of everything from ice cream cones to sandwiches is significant. Over the last several decades, typical portion sizes of high-carbohydrate foods have increased, and this makes it increasingly hard to eat moderately and trust our instincts. Large portions becoming commonplace has made it hard for us to decide when we are full and have had enough to eat.

That said, restricting carbohydrates is NOT the answer! One of the members of my Non-diet Book Club said this morning, “Any time there is a suggestion of deprivation, I go crazy.” As many weight-loss-diet veterans will agree, taking away foods creates a state of deprivation, which often leads to cravings and overeating of the “bad” foods. This is particularly the case when someone greatly decreases their carbohydrate foods -- especially grain products, like rice, whole grains (oats, quinoa, millet, etc.) breads, cereals, and pastas. In fact, I find that when someone eats less of these foods per day than their body needs, they often crave sugar, the simplest form of carbohydrate.

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So how much carbohydrate does one need to eat in a day? That depends a lot on your body size, activity level, metabolism, and the overall composition of your diet. If you are really lost here, seek out a registered dietitian to give you a reality check around how much carbohydrate and grain-based food is typical and minimal. Ultimately, you have at your disposal the ability to modulate your food intake quite well, if you are willing to slow down and listen to your body. Young children do it quite easily. My daughters’ guinea pigs do it well. But somewhere along the lines, we learn not to trust ourselves. We learn that someone else -- some expert or diet book author or nutritional guru -- knows better about what we need to eat. We choose what to eat from influences outside our bodies versus the knowledge that we have within. Again, if you feel really out of touch with your internal cues around food choices, as well as hunger and fullness, a registered dietitian/nutritional therapist, particularly one who has a specialty in disordered eating, may be able to steer you back to the path of intuitive eating.

Carbohydrates also supply glycogen to muscles. Carbs help active bodies recover from physical exertion, so it is particularly problematic for active people and athletes to eat too little carbohydrates. Fortunately, I find that most active people find themselves picking or binge-eating to make up for a diet low in carbohydrate -- and preoccupied with hunger. The body hates to be starved of major nutrients.

This cycle of restricting carbs (whether it’s intentional or not) and then overeating or binge-eating as a rebound is certainly distressing, and it can often be avoided if enough carbohydrate is eaten in the first place. I’m not minimizing the use of food for soothing, comforting, or other emotional coping, but there is often a nutritional reason for the compulsive eating along with the emotional ones.

To find out if you might be eating too little carbohydrates, check in with yourself. Does this sound like you...?

  • You find yourself binging or compulsively eating high-starch or sugar foods, particularly in the evening.

 

  • You feel weak, tired, and have less energy for physical activity than you used to.

 

  • You find that it’s harder to physically exert yourself two days in a row, as if your muscles take longer to recover than they used to.

 

  • You have cravings for sugar or sweet-grainy foods (like cookies, muffins, breads) that don’t just show up as part of pre-menstrual syndrome.

 

  • You find yourself drooling over your neighbors’ plate of pasta or root-vegetable stew and unable to enjoy your own more moderately-carb dish. (There’s nothing wrong with your lower-carb dish, by the way.  If you were eating enough carbs regularly, then you might not feel so deprived and just enjoy it.)

While the above conditions could be caused by other lifestyle or nutritional factors, these are the things that I find many of my clients complaining about when they are eating too little carbohydrate, particularly grain/starch-based foods like rice, potatoes, and grains.

Julia Child was a famous chef who lived here in Cambridge, Massachusetts for much of her life and lived to be 92.  Anyone who encountered her or watched her very popular cooking show would not deny that she celebrated the pleasures of food. She said, "Because of the media hype and woefully inadequate information, too many people nowadays are deathly afraid of their food, and what does fear of food do to the digestive system? I am sure that an unhappy or suspicious stomach, constricted and uneasy with worry, cannot digest properly. And if digestion is poor, the whole body politic suffers.”

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Life is too short to spend it afraid of noodles!  One of my great joys in this work is seeing clients find joy and peace in eating again, no matter what their individual path is to do so. “Bon Appetit!”

Gluten and Dairy and Sugar ... Oh My!

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I'm tired of struggling with food and thinking about food so much. I don't know if I should avoid carbs or sugar or gluten or what. And every time I do one of those things, I end up eating more of the crap that I don't want to eat.

One of my clients wrote that. I think it resonates with so many people’s experience of what I call Nutrition Information Overload. Many clients come to me after reading about someone’s journey to health and wholeness since going off dairy or gluten or all animal products or flour or sugar or (the list goes on...) They wonder, “Should I cut it all out, too?”  When I thought about writing on this topic, I had an image of the characters in the Wizard of Oz, huddling close in the forest repeating, “Lions and tigers and bears, oh my...”  On our way to the Emerald City of perfect health or contentment or a more peaceful relationship with food, we may be afraid of the forces lurking in our food supply, sure to take us off our paths down the yellow brick road.

Well, Oz imagery aside, I have become increasingly aware (over the 20+ years since I studied nutrition in college) that we are collectively more and more afraid of food. And I am not just talking about the increased number of eating disorders that are treated. I am reflecting on the way that it has become rather mainstream to give up gluten or dairy or sugar or meat or soy or all of the above... And while I will never argue that more fruits and vegetables are a good thing, I am concerned about the way in which certain styles of eating are making some of us feel more virtuous than others. And how badly people feel when they aren’t able to stick to a more “virtuous” way to eat.

As someone who has family members with food allergies and sensitivities -- and even has one herself -- I can appreciate the way in which certain foods can make us feel better or worse. Celiac Disease is a very real condition in which it is quite dangerous to be eating foods that contain gluten. Gluten, a mixture of two proteins that are found in cereal grains, particularly wheat, gives dough its elastic texture. It is wonderful that someone with Celiac Disease can find many restaurants and stores here in the greater Boston area with items that meet their dietary restrictions. It’s also great that food allergies are being taken seriously -- as many of them are life-threatening -- and that frequently ingredient lists are available.

Food sensitivities (versus allergies) are more difficult to identify and many clients come in wondering if they have some. The only real way to pinpoint whether or not you are sensitive to a certain food is to eliminate the one food (even little amounts of it) for 2 to 4 weeks, and then reintroduce the food back, monitoring for any symptoms. Symptoms are so subjective, so only you can determine if you feel better on or off certain foods. Food allergies/sensitivities mostly show up as symptoms in the lungs, throat, sinuses, or skin. They can also have behavioral consequences, like irritability, that are harder to pinpoint.

Gluten sensitivity is not Celiac Disease, but there is evidence that it is a real condition. Some people are indeed less able to tolerate gluten and will feel better if they don’t include foods with gluten in their diets. Again, when a true elimination is done for a short time, and then the foods with gluten are added back, those who are sensitive notice symptoms. One of my friends who is gluten sensitive swears that when he eats gluten, he feels like “his emotions have him instead of him having his emotions.” Who am I to disprove this experience? I always recommend that when someone feels that they might be sensitive to gluten, they get the test for Celiac Disease first. (They have to be eating gluten, though, in order for the test to be read correctly.) That way, the client knows if their gluten sensitivity could lead to more serious life-threatening problems if they don’t fully eliminate this food component. People with Celiac Disease shouldn’t even nibble on wheat bread or use cutting boards that were used to slice it. It’s that dangerous for them to eat gluten, so being clear about what kind of intolerance you have is important.

About two-thirds of people have a hard time digesting cows’ milk. Some people are intolerant of the carbohydrate portion of the milk (lactose) and have digestive symptoms. Some people are intolerant of the protein portion of the milk (casein) and have lung/sinus/skin symptoms. Some have both. With lactose intolerance, symptoms can vary from person to person. In other words, someone might have no symptoms with yogurt because the cultures added to yogurt help to break down the lactose and make it easier to digest, but then have major symptoms (diarrhea and bloating) after drinking milk. Some people’s lactose intolerance is mild, and they can eat all kinds of dairy products as long as they don’t have more than, say, two in one day.

When I discovered my daughter’s cows’ milk sensitivity, I noticed skin and sinus changes that completely disappeared when she stopped eating cows’ milk products for awhile. We kept allowing small amounts of cows’ milk in baked goods and butter here and there, giving her body a chance to slowly build up a tolerance. Today, she is adding back a little cheese when she is with friends without consequence and may be growing out of it. The way we manage and treat non-life-threatening food allergies and sensitivities in children is changing. (This could be another whole blog post some day...)

If someone does a real food elimination challenge and feels better not eating a certain food, then who am I to tell them that they must eat it?  However, I do always ask my clients to evaluate how much is the food elimination in the service of feeling better in their body versus trying to control their body -- or feel more control in their lives.

What I find most worrisome is the way that so many people today avoid certain food categories without really testing the reality in their own bodies. They just believe that because some celebrity feels good off gluten, then they must, too. I also worry when someone believes that taking away certain foods is the answer to their challenging relationship with food. For example, they believe that by eliminating sugar, flour, and gluten, they will halt their compulsive eating. I rarely find this to be true, even though I strive to work with my clients’  food preferences as they heal from whatever pain and suffering underlies the drive to cope using food. Most of the time, cutting out certain food groups just feels like another diet, and the research shows that most diets fail to be sustainable. (See my previous blog post about this:  Lose The Diet for Swimsuit Season.)

I acknowledge the addictive quality inherent in some foods in our food supply, but there is also more work to healing an addiction than just eliminating the addictive substance. Sometimes a client will cut out sugar, believing that it will make them feel more in control of their food choices or their life. At first, that is often how it feels, but generally the real reasons that their eating or their lives feel out of their control still exist. Instead of admitting that sugar-free was not the answer to their deeper life challenges, they often feel like a failure. And if someone tries to cut out lots of carbohydrate foods, they often end up craving these foods that are vital to our health.

All bodies are different and they respond to foods differently. In fact, our mood can effect how we respond to food, too. If you’ve ever had a stomachache before a major interview, do you blame the food you just ate or do you blame the stress about the interview? Sometimes it’s both. Certain foods “mix” better with stress than others. (Yes, comfort foods sometimes really are soothing.) Sometimes we aren’t even aware that we are stressed or anxious or keyed up about something. If our digestion is effected by it, we sometimes blame the food we ate, but it may simply be that the stress constricted and slowed down our digestion.

So, if you are wondering if it would help you feel better to eliminate some food or food group, go deep inside and ask yourself the following questions:

  • Do I want to eliminate this food because I truly believe that I will feel better in my body if I don’t eat it -- and not because I want to feel more in control of my eating, or my body, or my life?

 

  • Am I willing to try eliminating this food for 2 to 4 weeks (and is it safe and feasible for me to do so), then adding it back to notice the changes in my symptoms?

If you answered “yes” to these questions, then you might be ready to entertain the idea of testing yourself for a food sensitivity. But first ask the next two questions...

  •   Am I frequently under-eating, over-eating, or eating erratically (going long times without eating and then eating a lot all at once)?

 

  • Do I frequently eat emotionally, so that my emotions, thoughts, and stress might be effecting the way I feel when I eat food as much or more than the actual foods that I eat?

If you answered “yes”  or even “maybe” to one or both of these questions, then work on finding more balance in your life and eating before investigating food sensitivities.  Erratic eating is very often the culprit when it comes to gastrointestinal symptoms. Also, we ALL eat emotionally sometimes, but if you do so often, then working on your relationship with food may be more important than finding out if you have a gluten sensitivity.

A registered dietitian /nutrition therapist  who has expertise in disordered and emotional eating may be able to help you find some balance in your eating and help you decide if decreasing or eliminating foods might make you feel better. Beware of any nutrition professional who tries to give you a prescriptive way of eating or tells you to eliminate some foods that you don’t have a self-tested allergy or sensitivity to. Find a nutrition therapist who is interested in your relationship with food and your body and will tease out any of those issues first before doing a food sensitivity challenge. My clients often hear me saying that there is a difference (and it can be a fine line) between not eating something because it’s aligned with your values to not eat it, and not eating something because it’s aligned with your eating disorder -- or desire for control over your body and weight.

On our way to the Emerald City of health and well-being, it is often not whole food groups or foods that we need to fear. In fact, the more that we eat with presence and mindfulness and listen to our bodies, the more we find that our bodies can handle a wide variety of foods, and that they most enjoy foods that are prepared with love, care, and attention. If you believe that not incorporating a certain food into your diet will help you feel better, work with your nutrition therapist to do so in a way that really listens to your body and what it has to say, instead of giving up gluten or flour or sugar or meat because it’s fashionable in certain circles to say that you do. Be your own investigative reporter, and get help and support if your relationship with food also needs help. Find a way to eat that makes YOU feel your best and allows you to get on with living your very own fantastic life!