Welcome to Ask Healthy Living -- our new column in which you submit your most burning health questions and we do our best to ask the experts and get back to you. Have a question? Get in touch here and you could appear on Healthy Living!
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"The day after a big meal, I go to bed feeling stuffed and wake up hungrier than ever. Why is that? Is my stomach actually expanding?"
-- Jessi, 30, New York
"I must admit that I get this sensation," says Dr. W. Timothy Garvey, Chair of the Department of Nutrition Sciences at the University of Alabama at Birmingham and Chairman of the Obesity Scientific Committee for the American Association of Clinical Endocrinologists. Several Healthy Living staffers also related. So the good news is that you aren't alone.
But there's bad news too. You stumped our experts. "The truth is, we don't have a rigorous scientific answer for this," Dr. Garvey told Healthy Living, echoing a common sentiment among all the researchers with whom we spoke. There were several plausible theories.
But first, more good news: it's not your stomach expanding. "There’s no truth to that at all," says Dr. David Greenwald, Associate Director of the Division of Gastroenterology at Montefiore Medical Center in New York. "It's more likely that the stuff they ate didn't fill them up properly. People who eat a lot, but don't eat good things are likely to feel hungry again [soon]."
Big meals are often celebratory, which means they may include foods that are decadent rather than nutritious: starchy vegetables like mashed potatoes, white dinner rolls, cake. Foods that fall high on the glycemic index can make your blood sugar spike, causing a surge of insulin to drag it back down. The quick vacillation in blood sugar can cause a disruption to the normal cycle of leptin -- a hormone secreted by the fat cells that signals to the brain when you've had enough to eat. Foods that cause this type of response can encourage what is sometimes termed "fullness resistance."
In other words, that big pasta festival for your birthday? It'll just make you hungrier. But meals full of veggies, whole grains and lean protein may not create the same effect. Then again, "people who are eating vegetables, leafy salads are probably not overeating," adds Greenwald.
Still, Garvey wasn't convinced that leptin and insulin were the culprits here. It takes weeks for leptin production to respond to a dietary change because it's related to the size of fat cells, rather than the contents of a single meal. Instead, he suspected that ghrelin, a completely different hunger hormone that controls short-term regulation might be responsible.
"Leptin is a long-term regulatory hormone. It increases overall the amount of calories you take in. If your fat cells get bigger, they make more leptin and that suppresses appetite. If fat cells shrink, they make less leptin and that stimulates appetite," he explains.
"But ghrelin is a hormone that is secreted by the stomach. When you eat something, ghrelin is suppressed, making you not want to eat more. As time progresses after meal, after several hours, ghrelin rises," he says. "Some people have more rapid and pronounced rises in ghrelin in response to what they eat and that makes them want to eat more."
So what can a person do to avoid the dreaded after-binge binge? Of course, the most obvious advice is to avoid it in the first place: reasonable portions can be celebratory too. Choose foods that will keep you full longer: things that are high-volume and low-calorie, like leafy greens, and full of protein and fiber, like beans.
Beyond that, all you can do is some damage control: eat a sensible, filling breakfast (oatmeal! egg-veggie scrambles!) and know that the increased hunger will pass.
Have a question? Ask Healthy Living!
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