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Susan B. Dopart, M.S., R.D.

Susan B. Dopart, M.S., R.D.

Posted: October 25, 2010 09:58 AM

Imagine you are out to dinner with a friend and the bread arrives at your table. You are not very hungry, but you think, "l'll just have one little piece." A few minutes later, you realize you have eaten three slices before your meal even arrives. What's going on here?

Even though you are not physically hungry, your body gave you the signal to eat. That's the work of three hormones in your body that control hunger -- insulin, ghrelin and leptin. They are important because the way these balance can impact your weight and health.

Insulin

Insulin is made in the pancreas and allows cells to take sugar or glucose from the blood stream to use as energy.

Approximately one-third of the population inherits a resistance to respond properly to insulin, which prompts the pancreas to secrete more insulin if you eat a meal high in refined or "simple" carbohydrates such as white pasta or white bread.

When the insulin does not respond normally -- allowing sugars to enter the cells of the body -- you can experience insulin resistant hunger. Rather than being physically hungry, you might experience it as a "gnawing" desire to eat.

If you consume meals high in refined carbohydrates on a regular basis, that are not balanced with respect to protein and good fat, you may continually crave carbohydrates.

"Just One..."

Think back to the restaurant example with the bread, or perhaps a recent party where you have helped yourself to a few chips, only to find that you ate a good portion of the bowl. Again, even though you were not physically hungry, your body gave you the signal to eat.

In these situations, you know what you are "supposed" to be eating, but your body continues to give you the signal to eat more carbohydrates.

Running on Empty

The more refined carbohydrates you consume, the more your energy levels fluctuate between high and low throughout the day. Consequently, you never truly feel like you are running on real energy.

Not to mention, your body isn't a good ally here. It prefers carbohydrates or glucose as its primary fuel. If you are eating a very high carbohydrate diet, your body will first try to utilize the carbohydrate before tapping into calories from fat or protein.

To make matters worse, you may not tap into your fat stores if you are trying to lose weight. If you continue to a diet high in sugar or simple carbohydrates, your body will prompt you to continue eating these foods, leading to increased hunger and chronic carbohydrate cravings.

Ghrelin Grows and Leptin Lowers

This first thing to know is that ghrelin makes you feel hungry and leptin causes you to feel full. An easy way to distinguish between the two is that ghrelin grows your appetite and leptin lowers it.

They work to your advantage when your diet is in balance and you are receiving adequate sleep. They work to your detriment when your diet is out of balance and you are lacking sleep. Most importantly, the macronutrients you eat -- carbohydrate, protein and fat -- strongly influence them.

Appetite Ups and Downs

David Cummings, M.D., of the University of Washington School of Medicine, has done multiple studies on how macronutrients affect the hunger hormones.

In 2007, he and his colleagues conducted a study that found:

• Proteins were the best suppressors of appetite
• Fats have a neutral affect on appetite
• Carbohydrates initially lowered the appetite, but then rebounded soon afterward with a vengeance -- causing the appetite to be even greater than before the food was introduced.

Sleep and Appetite

In 2004, Eve Van Cauter of the University of Chicago conducted a study to see if sleep deprivation altered appetite. They tested men who slept 4 hours for two consecutive nights followed by 10 hours of sleep for two consecutive nights. They found that after sleeping for 4 hours versus the 10, the men had:

  • Leptin levels that were 18 percent lower
  • Ghrelin levels that were 28 percent higher
The men said they were much hungrier than usual and craved salty, sweet food. One compounding issue: a drop in leptin can signal the body to slow down the metabolism.

In summary, sleep deprivation not only increases hunger levels, but lowers metabolism, not a good combination for health and weight loss.

How to help your hunger hormones work to your advantage:

1. Have protein at all meals, but especially at breakfast. Breakfast sets the appetite tone for the day so consuming some high-quality protein such as eggs, organic plain yogurt or cottage cheese with some nuts will lower your ghrelin levels and minimize a spike in insulin levels to keep hunger at an even keel throughout the day.

2. Stay away from refined-carbohydrate-only meals and snacks such as cereal, a bowl of pasta, crackers, chips and starchy snacks. Even having a healthy snack such as fruit alone can trigger a spike and a drop in insulin, so add some nuts or a piece of cheese with the fruit.

3. Put ghrelin to rest: Getting adequate rest keeps your ghrelin and leptin levels in check to allow for normal levels of hunger.

Susan is the author of A Recipe for Life by the Doctor's Dietitian. For more information, visit susandopart.com

 
 
 

Follow Susan B. Dopart, M.S., R.D. on Twitter: www.twitter.com/smnutritionist

 
 
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03:00 AM on 10/30/2010
Where did that statistic that a third of people are insulin resistant come from?

"The frequency of insulin resistance is observed to be 3% in the general population; a several-fold increase occurs in individuals with glucose intolerance."

From http://emedicine.medscape.com/article/122501-overview.
03:00 PM on 10/28/2010
What you are describing is insulin resistance where your body continually gives you the signal to eat carbohydrates throughout the day - calming this down requires a very specifc way of eating - especially at breakfast with protein, moderate carbohdyrates from specific sources and enough fat to balance. A Recipe for Life is a guide that helps those with insulin resistance and how to manage it from all aspects of life.

Susan Dopart, M.S, R.D.
www.susandopart.com
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DrP
11:09 PM on 10/28/2010
For many with insulin-resistance the optimal plan is to eliminate all carbohydrates with the exception of non-starchy vegetables. Are you acquainted with "The New Atkins for a New Year?" The dietary phases work like an elimination diet to determine carbohydrate tolerance, both in amount and type. The authors are the top scientists in the field of metabolism and have done a great job of creating a plan that understands that each individual has a different carb tolerance and that each of us needs to determine his/her own critical level for optimal health.
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Ranveig Elvebakk
Innovator, author and lecturer on weight and nutri
04:48 PM on 10/29/2010
Hello Dr P I love your comments about a certain diet guru who has become a nutrition authority and has the world transfixed based on misinformation and half truths. How can we tell poeple the truth and be heard? Ranveig Elvebakk, MD
02:00 AM on 10/29/2010
Thanks for your answer, I will check into this matter.
06:49 AM on 10/28/2010
What about the so called carbohydrate addiction? Ever heard about that? Or is it a kind of fairytale? I often got the feeling, I can't stand without carbohydrates. Proteins or fruits won't do... Any experience or knowledge on that?
06:41 AM on 10/28/2010
What about the so called carbohydrate addiction? Ever heard about that? Or is it a kind of fairytale? Is it just a habit? I often got the feeling, I can't stand without carbohydrates. Fruits or proteins won't do... Any experiences or knowledge?
10:07 PM on 10/27/2010
Can where you live also be a factor? This link takes you to a Web app that shows, on a map, the relationship between obesity and diabetes, and access to healthy food. http://tiny.cc/p5wl5
03:04 PM on 10/28/2010
Defintely. Having access to fresh produce is more of a challenge in certain parts of the country so frozen produce might have to be the option there. Also with the cold it is more challenging to exercise outdoors. Overcoming diabetes is very doable - there just needs to be the motivation and the importance of maintaining a lifestyle that prevents it.

Susan Dopart, MS, RD
www.susandopart.com
09:46 AM on 10/27/2010
Stay away from processed foods and that includes processed meats. It’s all the crap that they do to our food that makes it bad for us. Get can get your protein from a nice juicy steak and not salami and you will be fine. I’ve switched to a nice pork steak instead of bacon for my break meat. Protein with every meal is a must!
08:34 AM on 10/27/2010
It is also essential in helping your leptin work better! Fat cells produce leptin (the protein hormone that signals to your brain that you are full) and one would think that extra fat cells producing extra leptin would equal a sense of being full most of the day. However, just as insulin resistance occurs, so does leptin resistance and the brain no longer "hears" the "I'm full" signals and urges the body to eat more.

Worse, because the brain senses that a famine has occurred (because it is no longer "hearing" the leptin signals), it slows down the metabolism to conserve energy (including lowering thyroid production). This creates a vicious cycle of lowered energy and increased hunger which create more fat cells that produce more leptin and on and on and on.

As leptin is a protein hormone, you can not boost or support your leptin levels with oral medications as it will break down and become ineffective in the digestive system. Plus, for most people, the problem is too much leptin so don't spend money on the leptin supplements begin sold.

The best you can do is help your leptin work better by eating omega 3 rich foods, lots of fruits and vegetables and exercising most days of the week. Eat real food, not chemically created faux foods. Drink adequate amounts of water and teas and use stevia or xylitol as a sweetener, if you must.

Blessings,
Lynette
Author of Unlock Your Metabolism
02:15 PM on 10/27/2010
All I can say is... @Lynette Knows of what she speaks and you'd be wise to listen to whatever she says. I have personally witnessed wonderful results achieved by people she's served. Not only that, but she is truly a nice, friendly person of great 'Heart' who has only the Best of Intentions for all.
07:59 AM on 10/27/2010
well, this is what i think
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katmeyster
We don't have a spending problem.
11:11 PM on 10/26/2010
I have dramatically reduced my desire to eat unless I am hungry. I no longer have cravings for sugar or carbohydrates and I'm even less interested in snacks. It really is the insulin, and if you stop eating sugar, carbs, gluten, and processed foods -- you too will learn the freedom from food cravings.
10:56 PM on 10/26/2010
Most of medical research is biased, exaggerated or flat out wrong. As for diet claims, it's probably 90% wrong.
So I d just follow ancestral wisdom. You re not getting my cereal breakfeast away. I f I crave sugars, or feel hungry I drink water instead, and relax. Works 100% of time.
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frank day
Obama cares about all of U.S.
02:15 PM on 10/26/2010
Eat many small meals throughout the day. Every 2 hours or less have some small healthy morsel.
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07:19 PM on 10/26/2010
Bravo! add to that exercise and you have done better than some experts below.
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RMankovitz
Researcher, inventor, entrepreneur, author
02:06 PM on 10/26/2010
Food cravings may have nothing to do with these hormones. Anecdotal studies have shown that toxins in the body can generate intense carbohydrate cravings. Examples include candida overgrowth and parasites. Natural detox protocols can deal with them. Examples and references on these issues can be found in “Nature’s Detox Plan.”

Roy Mankovitz, Director
http://www.MontecitoWellness.com
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spitfiredd
My micro-bio has got it going on.
03:12 PM on 10/26/2010
What about serotonin and melotonin levels as described in this study:

http://web.mit.edu/newsoffice/2004/carbs.html
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RMankovitz
Researcher, inventor, entrepreneur, author
05:04 PM on 10/26/2010
In my opinion, this was a strange study trying to show why certain people have late afternoon carb cravings by measuring brain serotonin levels, particularly when the bulk of the serotonin produced in the body is in the gut, not the brain.

In my opinion, the authors completely missed the real issues and failed to account for significant confounding variables. My approach would have been as follows: for those with carb cravings, perform stool, saliva, urine and blood tests looking for signs of candidiasis, parasite infestation, and antibodies to gliadin (gluten). Also perform a thyroid panel, including free T3, a saliva cortisol and DHEA panel, check buccal cell magnesium levels, as well as iodine and bromine levels. I would also do a glucose tolerance test in the afternoon time period. I would take a history looking for major antibiotic use in the past, use of the Pill or steroids, a mouth full of metal and root canals, and exposure to environmental toxins.

What you are likely to find is that the carb cravers are toxic waste sites, loaded with fungal and other parasitic infections, causing subclinical hypothyroidism, adrenal insufficiency, hypoglycemia, vitamin and mineral deficiencies, and possibly subclinical celiac disease. When these afflictions are treated properly, the carb cravings miraculously disappear, along with a host of other symptoms.
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07:01 PM on 10/26/2010
Excellent, rebuff with "Anecdotal studies " to tie-in with your I don't even know what to call it. I tutored Anatomy and Physiology for years and know the importance of sound Medical research to back-up a
diet plan. I quote from your site "the need is urgent: medicine doesn’t work, but rocket science does."
I find that statement, yes I reviewed your claims, and find it irresponsible. You can dress-up 'snake oil' but it's still snake oil..........not in my body bub, stick to rockets!
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RMankovitz
Researcher, inventor, entrepreneur, author
08:25 PM on 10/26/2010
Thanks for sharing your personal opinion.

I wish you the best of health.
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Dustin Rudolph
Clinical Pharmacist & Certified Nutritionist
01:28 PM on 10/26/2010
I think the emphasis needs to be put on limiting or avoiding completely refined carbohydrates/sugars as these lead to not only an increase in cravings but an increase in visceral adipose tissue (belly fat). Also protein from meat and dairy has been shown in multiple studies to be detrimental to health and should be limited to less then 10% of your total daily caloric intake.

Doug Lisle wrote a great book about food cravings and how to overcome them as a part of a healthy way of eating. His book is called "The Pleasure Trap".

Dustin Rudolph
www.PursueAHealthyYou.com
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onionboy
Blessed are the Cheese Makers
10:54 AM on 10/26/2010
I try to eat high protein and high fiber meals. It can be a tricky balance, but it helps me with appetite, "regularity", and weight. And I drink a ton of water, just to keep my mouth busy sometimes. For protein I stick to lean meats and egg whites (love that they sell them in cartons now for scrambled eggs). For fiber, typical fruits and vegetables and I love the taste of the Fiber One bars.
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DrP
11:13 PM on 10/28/2010
Why not eat whole eggs from the original package (the shell)? I really don't get why people eat just the whites. No compelling reason not to eat the yolks and that's what makes the eggs worth eating.
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onionboy
Blessed are the Cheese Makers
02:15 PM on 10/29/2010
You have a lot more free time than I do, I guess. And I eat egg whites because it's pure protein. I would be eating quite a lot more calories if I ate yolks. As I said, I try to focus on high protein and high fiber. That's not egg yolk.
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DrP
11:15 PM on 10/28/2010
And Fiber One? Isn't that just a bunch of sugars and refined grains? Not the best choice. And I'll bet they are full of artificial stuff and preservatives.
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11:43 AM on 10/29/2010
Yes they are. But they are so good and an easy snack on the go. Plus all that fiber goodness.
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onionboy
Blessed are the Cheese Makers
02:12 PM on 10/29/2010
What, do I have to be the natural food police? They're good. I don't hold an prejudices against refined sugars and grains, though the grains must not be too refined, given the fiber content. Artificial this & that, maybe, but there's no data that will hurt me in the long run. If you want to eat all natural, that's up to you. Personal preference.
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Thinklongterm
Conservatives are a disease....we are the cure.
06:40 PM on 10/25/2010
Good info. Thats why my all fruit breakfast makes me hungry only a few hours later.
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uansari1
10:22 AM on 10/27/2010
My typical breakfast for the past couple months has been 16 ounces of whole fruit (blueberries, peaches, strawberries, banana), 4 ounces of pomegranate juice, and 4 ounces of light soy milk. The soy milk is the only source of protein, but back to my original point, I always thought that the natural fiber content of whole fruit would adequately slow down the metabolism and absorption of the fructose. Shouldn't eating whole fruits for breakfast work differently than eating "refined carbohydrates", such as cereal, etc.?
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DrP
11:19 PM on 10/28/2010
No. Fruits are full of sugar, fructose to be exact, and are not the great health food they have been touted to be. For people with insulin-resistance, fruit is not a good choice. Non-starchy vegetables can provide all the needed fiber and vitamins. Some insulin-resistant people can handle a small amount of low sugar fruits such as berries; others are best to avoid all fruit. I am one who can't handle the sugar even in berries, so I stick to green veggies.