Discussion reviewing a range of factors that influence taste preferences and cravings for refined starch and sugar. Specific recommendations to reestablish a more grounded metabolism and effective self

1. Strategies to tame sugar
and other food cravings
Bonnie Y. Modugno, MS, RD
www.muchmorethanfood.com

2. 



Discuss what influences
cravings for sugar
and/or refined starch
Explain how the body
responds to excess
sugars and refined
starches
Survey the current food
supply’s role in driving
food cravings
Explore strategies to
reduce cravings and
intake of sugar and
refined starch
Sugar/Starch
cravings
Ways to
reduce
cravings
Body’s
response
Food supply

3.  Develop
during
gestation & are
detected at birth
 More sensitive for
babies
 Reinforced with
breastfeeding or
formula feeding
 Continue to
dramatically change
through childhood
Grill & Berridge (1985); Grill & Norgren (1978).

4.  Varies
between people, gender, cultures
 Can vary at different times for one person
 Changes with the intensity of sweet


Optimum amount of sweetness
Never too much

5.  Genetic,
Epigenetic
 Familial/Cultural
 Sensory
Mouth feel
 Texture

 Behavioral

Reward
 Economic

Subsidized food
supply
 Biochemical
Glucose tolerance
 Hyperinsulinemia
 Insulin resistance
 Leptin resistance

 Microbial
 Neurological
Dopamine
 Serotonin

 Environmental

6.  Family



History
Diabetes
Central body fat
Weight struggles

7.  Mom’s


Central body fat
Poor metabolic health
 Mom’s


health status before pregnancy
health status during pregnancy
Fast or excessive weight gain
Gestational diabetes

8.  Mom’s
diet
before & during
pregnancy

Babies detect
aroma, flavors in
amniotic fluid
 Mom’s
diet when
breastfeeding

Babies detect
aroma, flavor of
breast milk

9.  25%
of population
are “non” tasters
 50% are medium
tasters
 25% are considered
“super tasters”


35% of women
15% of men

10.  Mostly
a biological
phenomena

More sensitive to
bitter



Often prefers sweet
? Prefers starchy
May be linked to
“picky eaters”, but
not always

11. 
Copyright © 10/7/05 Los Angeles Times
Taste preferences
 What parents eat
 What is special or
valued
 What may be
used as a reward
or bribe

19. 90
Soda
2.5
80
Bread
70
60
2
Potat
o
chips
Cooki
es
40
30
20
10
0
100 Calories
Cost in cents
1.5
Licori
ce
50
0.5
Orang
e
Organic
Milk
Organic
Apple
GF Beef
0
1
WC
Salmon
100 Calories
Cost in $$

23. How


does your body respond to what you eat?
More important than the total calories we eat:
Do you burn energy or store it?
Evidence of an “efficient” metabolism






Central obesity or deep visceral fat stores with
normal weight
Pre-diabetes, Type II diabetes, gestational diabetes
PCOS (number one cause of infertility)
PMS, irregular periods
Fatty liver or elevated liver enzymes
Elevated triglycerides, low HDL-Cholesterol levels

24. NW
Obese
Lomenick J P et al. JCEM 2009;94:4463-4471
©2009 by Endocrine Society

25. NW
Obese
NW Pre-adol.
Obese Pre-adol.
Lomenick J P et al. JCEM 2009;94:4463-4471
©2009 by Endocrine Society

26.  Gut
microbes influence
inflammation, immune response, bowel
function, appetite, metabolism, even sugar
cravings (linked to insulin sensitivity)
 What
you eat influences the majority (57%)
of gut bacteria


Short term within days of eating
Over time

27.  Factors
that shape
microbiota
maternal stress
 mode of delivery
 feeding method
 introduction of solid
foods
 antibiotic exposure

Christoph Reinhardt, Christopher S. Reigstad, and Fredrik Ba¨ckhed. Journal of
Pediatric Gastroenterology and Nutrition. 48:249–256 © 2009

28. 
Favoring obesity


High fat, high sugar diet


Antibiotic use
Excessive carbohydrates, especially refined
sources
Favoring leanness

More complex carbohydrates

29. 
Food is not ordinarily like a
substance of abuse, but
intermittent bingeing and
deprivation changes that.

Sweet taste elicits release
of dopamine in the brain
Avena, Rada and Hoebel. Neurosci Biobehav Rev. 2008; 32(1): 20–39.

30. 
Different brains have
different responses to
sugar

For some, the pleasure
trigger is the first bite

Wanting more is a
natural response

Excessive intake with
diminishing pleasure is
signs of a system gone
awry

31. Most of us live with greater insulin resistance
today which can drive sugar cravings
 All of us carry a “body burden” of chemicals
known as endocrine disruptors or persistent
organic pollutants that interferes with normal
metabolism
 95% of these agents enter our bodies via the food
supply


32. Sources and Pathways to Human Exposures
SOURCES
TRANSPORT
Reentrainment
DEPOSITION
Industrial
Processes
Combustion
Direct
Discharge
Runoff
Erosion
FOOD
SUPPLY

33.  BPA



Mimics estrogen in the body, binds estrogen
receptors
Estrogen regulates fat metabolism
Elevated BPA linked to breast
cancer, reproductive problems, obesity ,early
puberty and heart disease

34.  Other





endocrine disruptors, target organs
Pesticides (atrazine) ---- reproductive hormones
Plasticizers (pthalates) ----reproductive
hormones, glucose tolerance, thyroid function
Industrial pollutants (dioxin) ---- impairs immune
system, reproduction, metabolism, nervous system
Fire retardants (PBDE’s and related compounds)
---- thyroid function
Perflurochemicals (PFOA—used to make non-stick
cookware) ----reproductive hormones and thyroid
function
In 2012 the American Academy of Pediatrics called
for a re-examination of our chemical policies

35. Sugar/Starch
cravings
Body’s
response
Food
supply
What we buy
What can you do?

36.  Weaning
yourself will be challenging

37.  Emphasis
on
assessing hunger &
satiety

Confusing cues



Expectations



Lack of satiety
“Needing something”
Calorie intake
Right way to eat
Confounding factors



Stress
Sleep deprivation
Unmet needs/wants

38. --but maybe eat less total carbohydrate, too

39. 250
200
Pounds
150
Total Grains
Total Sugar
100
50
0
1950's 1960's 1970's 1980's 1990's
2000

42.  Balanced



Adequate protein
Emphasize whole plant foods with rich fiber
content
Enough healthy fats
 Adequate

meals
calories per meal
500-700 kcal for most women (3 meals + snacks)

48. BLOOD GLUCOSE
Refined
Starch/ Whole Grains
Sugar
Vegetables/Fruit
Legumes
Protein +
Beans/
Carbohydrate
0
5
1
2
Protein/Carbohydrate
+ Fat
3
TIME AFTER EATING (hours)
4

49. Too often food is a form of
entertainment
or self soothing, not connected to
hunger or energy needs

50.  Cultivate
effective self regulation &
resilience

Build your tool box

Identify options that fit
 Time of day
 Available time
 Budget limitations

51.  Cultivate

effective self regulation, resilience
Practice exquisite self care



Adequate sleep
Adequate down time, recreation
Activities you enjoy

52. 1-2 minutes
5-10 minutes
30 min
Phone call to a friend Walk outside
Take a walk
Look at fresh flowers
Drink cup of tea
Use yoga balls
Listen to music
Read the newspaper
1 hour
2-3 hours
All Day +
Yoga class
Hike in the
mountains
Day at the beach
Mani-pedi
Massage
Bike ride excursion
Meal with a friend
Read a good book
Spa
Browse an antique
store
Go to the movies
Travel

53. •Eat
through
your day
•Avoid
getting
over hungry
•Stop
when
satisfied

54. 
Plan for treats, when you
are ready





Not every
opportunity, not every
day
 3 day weaning
Enjoy after a protein
based meal
Swap out starch at the
meal
Choose a modest
amount of something
delicious
If possible, manage
frequency by not
bringing larger portions
into the house

55. Question & Answer
Bonnie Y. Modugno, MS, RD
www.muchmorethanfood.com