I’m a very visual person. When I meet a patient who presents with complaints of irritability, anxiety, foggy thinking, fatigue, and insomnia, I visualize something that looks like a concert of rising and falling graph lines, and I plot her day-to-day symptoms on this image. What I find is that the sugar roller coaster accounts for the vast majority of symptoms troubling patients.
We know that sugar influences behavior; we see it in our kids and know not to give them a lollipop if we want them to read a book quietly at their desks. Somehow, though, we're not convinced of the powerful effects of this toxic substance on our adult bodies and brains. Sugar disturbs mental health in at least three ways:
1. It starves the brain.
Here’s a typical scenario. You wake up, have a glass of orange juice and a bagel, and your pancreas is confronted with a wave of sugar that it doesn't react kindly to. It releases its own wave of insulin, charged with sweeping that sugar into cells for energy production. The resultant dip in blood sugar can alarm the body and the adrenal glands, making them work overtime. These glands are charged with producing cortisol (which ultimately promotes insulin resistance or the lack of cellular response to insulin) and fight-or-flight chemicals that can get your heart racing and ratchet up anxiety. The solution to this agitated slump is often a follow-up serving of refined carbohydrate and/or caffeine and sugar — maybe a midmorning cookie with coffee.
The more days of your life you engage in this pattern of sugar and refined carb consumption, the more your brain suffers, potentially even putting you at risk for Alzheimer's dementia down the line.
2. It fuels inflammation.
Sugar has direct inflammatory effects on the body that may be related to its influence on gut flora, its associated insulin spike, or glycation effects of circulating sugar on proteins. Inflammation may be a major driver of chronic disease, including mental illness, and is promoted by sugar, stress, and environmental toxins.
3. It derails hormones.
When cortisol is in demand for its blood sugar-balancing effects, the body “shunts” the production of progesterone to support further cortisol output. This makes evolutionary sense, because if we are under stressful circumstances, preserving progesterone, our “progestational” reproductive hormone, becomes secondary. Insulin can also stimulate production of DHEA and sex hormones, including testosterone, which can drive the pathology we see with polycystic ovarian syndrome. As if that weren’t enough, sugars can reduce liver production of sex hormone-binding globulin, freeing up testosterone and estrogen in ways that may promote symptoms of estrogen dominance, including premenstrual moodiness and irritability.
So, how do you kick the habit? For my patients I recommend a 2-4 week sugar fast, following some basic guidelines. Everyone knows that sugar in the form of candy, cake, and ice cream is the first to go on the chopping block, but here are three less intuitive sugar balancing changes:
1. Boost the fat.
The hallmark of the Paleo diet, high natural fat intake, including saturated fat, is the antidote to much that ails the Standard American Dietary victim.
I recommend that my patients use liberal amounts of grass-fed ghee, coconut oil, and cook with animal fats from pastured sources in addition to frequent consumption of bone broths.
2. Ditch the grains.
Thanks to Dr. David Perlmutter’s best-selling book, Grain Brain, the public now has an awareness of the insidious role of grains, including whole grains, in blood sugar destabilization and brain health. I'm concerned primarily about grain-based toxins such as inflammatory lectins in wheat, genetically modified corn, and changes to the prolamine content of grains since hybridization techniques have taken hold. These grains are rarely traditionally prepared (sourdough, sprouted) in ways that would aid in their less inflammatory digestion, and are almost always featured in processed foods. I recommend a one-month elimination of all grains.
3. Make room for starch — safe starch.
Rigid interpretation of low-carb Paleo diets may leave some women feeling strung out after an initial boost. The role of thyroid hormone in the transition to a low-carb diet suggests that a thyroid hormone called reverse T3 may be produced as a way to signal the body to slow down, and insulin resistance may actually result as a way for the body to hold on to that suddenly dwindled supply of glucose. For these reasons, I recommend incorporation of non-grain “safe starches” into my patient’s diets. It may come as a surprise to learn that certain carbohydrates may actually help to balance blood sugar.
An interest in food-based nutrient synergy will make clear the distinction between a sweet potato and its caloric equivalent — four teaspoons of table sugar. The former comes packaged with the B vitamins, phosphorous, magnesium, iron, copper, manganese, zinc, and chromium needed to metabolize the carbohydrate content, in addition to vitamin E, beta-carotene, vitamin C, calcium, potassium, zinc, and selenium. This tuber improves blood-sugar stabilizing adiponectin and reduces inflammation. But isn’t it high glycemic?
Herein lies the limitation of the glycemic index. Investigation into the “high-carb” traditional Kitava diet reveals that "yam sweet potato, taro, and fruit were staple foods while grains, dairy, refined fats, and sugar were absent. The study adds to the notion that some of our most common diseases are preventable and that a high-carbohydrate intake is not a problem in itself."
It takes about one week to reset your sweet tooth, but there's a profound liberation that comes with elimination of addictive foods such as dairy, sugar, and grains. From this experiment emerges the “real you,” free from the influence of industrial food toxins. Only then can you know what your mind-body “issues” really are.