January 16, 2024 • 24 mins
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Discover how to liberate yourself from the clutches of sugar addiction with the insights of Dr. Nicole Avena, whose groundbreaking research shines a light on the hidden ways sugar is controlling our lives. In our candid conversation, Dr. Avena, armed with knowledge from her acclaimed book "Sugar List," presents a seven-step plan that guides you toward breaking free from sugar's addictive grip. We take a deep look into the historical shift that piled sugar into our diets and unravel the complex web between sugar consumption, mental health, and inflammation. If you’ve ever felt powerless against cravings or struggled with dietary changes, this episode offers the tools to start a transformative journey towards better health.
As your host, Bettina Brown, I'm thrilled to share this empowering discussion that not only equips you with strategies to conquer sugar's stronghold but also invites you to become part of a supportive community eager to lift each other up in wellness.
We emphasize practical steps like the eye-opening three-day food diary and simple swaps that can drastically reduce sugar intake, starting with sugary drinks. Tune in to join our collective mission to make informed dietary choices and pave the way to a healthier, happier life—with Dr. Avena's expertise guiding us every step of the way.
Learn more about Dr. Avena.
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Transcript
Episode Transcript
Available transcripts are automatically generated. Complete accuracy is not guaranteed.
Bettina M Brown (00:06):
Hello and welcome to In the Rising a
health and wellness podcast forthose going through and those
supporting those going throughcancer.
My name is Bettina Brown andI'm board certified in physical
therapy, wound care andlymphedema.
And you know, for me cancer isvery personal.
It's affected my friends, myimmediate and my not so
(00:26):
immediate family, and thereforeI created this podcast and fit
after breast cancercom toaddress the multiple dimensions
of our lives during and afterrecovery.
Hello, hello and welcome to Inthe Rising podcast Today.
(00:48):
I'm really excited to introduceto you Dr Nicole Avena, food
sugar addiction expert, becauseshe has a PhD in it from
Princeton and has spent over 20years looking into this, helping
us learn how to navigate ournutrition.
Nutrition and how reallynutrition is medicine.
(01:08):
So I'm really excited for youto listen today.
Good morning, good morning, drNicole Avena.
How are you doing today?
I am great, it's nice to bewith you, thank you.
Likewise, I've read about you.
I've read your new book,sugarless, and what I'm really
fascinated about you is thatthis is a topic that is a part
(01:32):
of your life.
This is a huge journey for you.
Can you share a little bitabout your background?
Dr. Nicole Avena (01:37):
Yeah.
So it's interesting, I cameinto this field in a very, I
guess, sort of unique way.
I've never, luckily, had anyissues with eating disorder or
my health related to diet.
I actually came into thisbecause I was starting my PhD at
Princeton in neuroscience and Iwas talking with my advisor
(02:02):
about what kind of project Imight work on for my
dissertation, which is this huge, massive, five-year-long
project.
And one of the things that westarted talking about and this
is going back to the year 2000,2001, was that at the time a lot
of people were struggling withobesity and we were hearing more
about it in the media.
(02:22):
But the idea was that it's theirfault, it's a moral failing,
they don't have willpower.
And we started to think well,maybe there's something more to
this.
Maybe the highly processedfoods that have tons of added
sugar that are really justeverywhere these days are doing
something to people and it'smaybe making them addicted.
(02:42):
And just like people getaddicted to drugs or alcohol,
maybe some people could getaddicted to sugar and that could
be why it's so hard for peopleto eat healthy.
And so that kind of led me downthis journey that I've been on
ever since of studying whetheror not sugar could be addictive,
and from there I have beenstudying how sugar affects our
(03:03):
overall health, how it affectsour mental health, and what
we've learned has just beenfascinating, and there's just so
much research now that's beenpublished on this topic and it's
just something that's reallybeen near and dear to my heart.
Bettina M Brown (03:19):
Well, thank you for sharing that.
And when I was reading aboutyou, you were talking about your
graduate work on rats and therewas this one line and you said
rats and mice have similarneural circuitry to humans and I
laughed out like literallylaughed out loud because I
thought, wow, this is a эта Sadand good at the same time.
(03:42):
But what you also mentioned isthat the rats also developed
some, some tendencies that Ifelt Connected to, and I don't
have the word out in front of me, but there was a resistance to
extinction, like when the lightbulb was out, sugar was not
available, but they still wentto it.
Can you share a little bit moreabout what you've noticed about
(04:03):
that sort of mental habit?
Dr. Nicole Avena (04:06):
Yes, and I think that you know these
studies that we, you know,initially conducted in our
little lab rats.
In many ways, you know, itreminds me of what happens to
humans.
And so in our lab rats what wefound is that if they're used to
pressing a lever to get sugarright, then all of a sudden one
day the lever doesn't work, thelight bulb isn't on.
That signals the sugarsavailable.
(04:27):
Their resistance to extinctionemerges in the sense that
they're not going to extinguishthat response.
They're not going to justrationally stop pressing the
lever right.
If you know that there is, youknow, no sugar available, the
lights not on, the bar is notgoing to give you anything to
drink, then there's no sense inpressing the lever.
But what ends up happening?
(04:48):
If you're really cravingsomething, then they're going to
keep on pressing that lever.
And that's what we see in ourlaboratory rats and we also see
that in our people when youthink about it.
I mean, if you know there's noDessert in your refrigerator,
but you just open it up anywayand stare off into it, and you
know.
It's again something that Ithink we can see happening on
(05:12):
the human level in many caseswhere people are craving sugar
and it really does, I think,speak to how Powerful those
cravings can be and why it canbe difficult for a lot of people
to not give into them when theydo occur.
Bettina M Brown (05:27):
Yeah, and you also describe in the book that
we kind of gave ourselves someof this problem by trying to
eliminate another problem,trying to eliminate fats.
Can you share a little bit likehow did we end up here?
Dr. Nicole Avena (05:42):
Yeah.
So I think this is reallyinteresting because it's kind of
part of the social history ofOur food environment, which I
think is really just fascinatingbecause there's so much
psychology in it.
So what really happened forthose that can remember back
during this time, who were alive, you know, back in you know the
1980s and 90s, we reallystarted to see this big push
(06:07):
toward Minimizing fat and therewas this very big media push and
medical community push toreduce fat in your diet, because
fat had been linked tocardiovascular disease and so
fat became demonized.
And I remember being a kid andyou know my mom Would try to be
(06:27):
healthy, so she would go to thestore and buy these cookies that
were fat-free cookies and itwas literally like a license to
be able to eat as many as youwant because they were fat-free,
so they're good for you.
The problem was that when youtake the fat out of food
products, you don't really havemuch flavor, and so in order to
make them taste good, you got toput some sugar in.
(06:49):
So all these fat-free productswere loaded with sugar and other
carbohydrates and so, althoughwe were good about getting away
from fat, we inadvertently endedup getting hooked on sugar as a
society.
And so now what we're seeing isthe effects of that in terms of
, you know, rising obesity ratesobesity, you know, being so
(07:12):
pervasive across the country andAlso all of these medical
complications that can comealong with eating too much added
sugar.
You know, it's not justoverweight or being obese, it's
cardiovascular disease, it'sdiabetes, it's fatty liver
disease and, on top of that,it's also mental health issues
that can arise as a result oftoo much sugar.
(07:34):
So it did start off by, likeyou said, you know, trying to
fix something that was a ryewhere, you know, yeah, fat
wasn't good for our heart, butin the end, I think we often
really do more damage than wedid help, because it's something
that we basically just replaced, you know, one bad thing with
another.
Bettina M Brown (07:55):
Absolutely, and I think, ultimately, the quest
is always to find this health.
But everything has a varietyfor a reason.
I think that's what we'recoming about and, as I've done
some of my own research, ouraddiction makes people money.
Also, there's food companiesthat literally will Take chips
(08:17):
and Find out what is the rightamount of crisp that makes us
have a little dopamine hit right.
So we are creating, we are ourattention, our food choices are
really Benefiting some people.
So I think some people aremotivated by wanting to be
healthy, some people aremotivated by anger and some
people are more by fear.
(08:37):
So Whatever it takes to reallychange that.
You also shared this one thingthat rats preferred the sugar
over cocaine, and I think that'ssomething to to really take a
moment and pause about.
Can you describe that?
Dr. Nicole Avena (08:54):
Yes, I think this is one of the more popular
studies that's been discussed,because it is really, I think,
alarming when you think about it.
And so, in this study, ratswere offered a choice between
sugar, water or cocaine, andthey overwhelmingly decided that
they would rather have sugar.
(09:14):
And so, again, you know, weknow that cocaine is a very
powerful addictive drug, and thefact that rats are willing to
consume sugar in place of it tome is really telling in terms of
how powerful sugar is and howit can affect the brain.
And I think that it isinteresting too from the
(09:35):
standpoint of, you know, we allknow that cocaine's not good for
you and you shouldn't use it,but in our modern society, I
mean, we really do notdiscourage sugar use.
It's celebrated.
I have little kids, and so I seethis in the schools all the
time, where you know everybodygets a lollipop or everyone's
(09:56):
getting candy, or you know it'ssomething that's really heavily
promoted, especially among youngpeople, as you know, being a
socially acceptable, normalthing.
And I think that that makesthis all the more dangerous
because what we're findingthat's happening is that, over
time, yeah, kids might, you know, be healthy when they're young,
(10:17):
but if we're in training themto be addicted to sugar when
they're five or six years old,then what's that gonna mean for
their health when they get olderand those habits are gonna be
really difficult to break.
Bettina M Brown (10:30):
Absolutely, and thanks for pointing that out
about how we're training.
You know our kiddos and I willshare that my I'm a mom as well
and when my son was young, Iwould try to take the lollipop
and say, let's save that foranother time, let's have some
carrots or this.
And I remember this one timethat he just said I want sugar,
(10:51):
and it made me pause.
I literally stopped moving andI thought, wow, this is this
process already unfolding,because that's what they get a
snacks at school and a reward.
Dr. Nicole Avena (11:04):
Yes, and I think that's something that,
over time, we just need tochange.
I think, you know, 50 years agoit was fine, you know, for the
teacher to give out candybecause that might be the only
sweet thing that the kid had allday, but now, I mean, it's just
one of the you know 99 sweettreats the kids are having
(11:27):
throughout the day.
So I think it's reallysomething that we need to
revisit in terms of rewardingour kids for their good behavior
.
And, you know, we have to keepin mind, if we know that this is
bad for their health, it's nota reward, If anything, it's a
punishment.
And so we need to just, I thinkyou know, make some changes
around that socially so that wecan, you know, help our kids to
(11:49):
get on a good track for goodhealth as they get older.
Bettina M Brown (12:01):
Absolutely.
And, Dr Avina, you've mentioneda few times sugar and mental
health.
Can you expand on that a littlebit?
Dr. Nicole Avena (12:08):
You know, this is one of the things that I
found to be surprising.
I wasn't really expecting thisto be one of the outcomes of
cutting back on added sugar, but, overwhelmingly, when people
that I work with or talk withwho have been able to reduce the
amount of sugar in their dietand get away from it, will
report that they're surprised athow it affected their mood and
(12:32):
how it made them feel so muchbetter and how they felt clarity
of thought, how they didn'thave that brain fog anymore.
And I think, from the biologicalstandpoint, it comes down to
the fact that sugar is highlyinflammatory and when people are
consuming it in excess, it'sgonna have an inflammatory
response, and that can happen inour brain.
(12:53):
And so when we're able toremove sugar and reduce it, it
really does help our brain toheal and, as a result, we're
going to see things like youknow improved mood.
We're gonna see things like youknow, not having achy joints
all the time and we're gonna see, you know, these other
unexpected but yet pleasantconsequences of cutting back on
(13:17):
the added sugar.
And I think for the mentalhealth piece especially.
I mean we hear so much aboutmental health these days and how
many people are struggling withmental health issues, and I
think for all of us, it's in ourbest interest to look at our
diet when we think about ourmental health, because that's
something that you can easilychange, and if it's gonna
(13:38):
improve your mood and help youfeel better, then why not?
It's something that I think weall could benefit from.
Bettina M Brown (13:46):
Yes, yes, and you know, with lots of
inflammation come along otherissues, like you even mentioned
the joints.
What about this other topic?
And then we're gonna go intothe second part of your book
about obesity and sugar.
I feel like there are sometimes, just when I look at it as a
(14:07):
regular person, like well, can Ihave some sugar?
Can I not have some sugar?
Are they hiding sugar in otherplaces?
And then is this going to makeme fat?
Dr. Nicole Avena (14:18):
Yeah, I think that it boils down to your
relationship with sugar andwhether or not you're in control
, and I think that's really thegoal of my book sugar list is to
help people to get the controlback, because for many people
who are addicted to sugar, thesugar is in control right.
The sugar is telling them Iwant you to eat more of me, I
(14:39):
want you're going to havewithdrawal, you're going to have
to crave me, and that's not howit's supposed to be.
And so it's really aboutgetting to the point where you
can enjoy sweet treats and beable to say, okay, I've had
enough, I've had one piece andthat's all I need to feel good
or to enjoy myself.
And so it's not about reallyjust completely cutting
(15:00):
everything out.
I don't think that'ssustainable, I don't think it's
possible and I don't think it'snecessary.
I think it's more about gettingcontrol back, and I think, when
it comes to our diet andobesity, I think for many people
, yes, that is something thatthey're concerned about.
If people are trying to loseweight or want to have a healthy
body weight, cutting out sugarcan be one of the easiest ways
(15:24):
to do that to reduce your bodyweight, and starting with
beverages, I think, is reallythe spot to start, because a lot
of our beverages are loadedwith added sugar, and it's not
just sodas and juices, which weshould avoid, because those are
really just empty calories andloaded with added sugars that
are going to provide nothing butexcess body weight to us.
(15:45):
It's even the coffee drinks.
This has become.
One of the things that I'vebeen noticing a lot more and
more is that you go to a coffeeshop these days and basically
it's a dessert.
I don't even know if it'scoffee anymore.
It's so much sugar in it.
I think there's more sugar thanthere is coffee in the products
.
So it's really about, I think,just revising your relationship
(16:07):
with sugar and making sure thatyou're in control, and that's
what I walk people through inthe book with the different
seven step plan that I offer forpeople to just get control back
.
Bettina M Brown (16:18):
Absolutely, and it's sugarless a seven step
plan to uncover hidden sugarsand curb your cravings and
conquer your addiction, and oneof your steps is to do a three
day food diary to actually knowwhat you're eating.
From many people that I've hada conversation with, this is
almost like the most difficultpart is to really do this food
(16:39):
diary.
Do you feel that it's kind ofhard to face what you're eating
because it's three days of justwriting some things down, or do
we have shame with what we'reeating?
Dr. Nicole Avena (16:51):
Well, I really try to encourage people, when
they do this important step, tonot feel shamed, not to reflect
on themselves like oh my gosh, Ican't believe I'm eating all
this stuff, or look at thesetwins.
It's about getting a realisticpicture of what you're actually
eating on a day to day basis,and I think for a lot of us, you
(17:11):
don't realize it until you putit down and writing and are able
to see how little bits of sugarhere and there become sugar
everywhere.
And when you add it up and yousee how okay, the coffee that
you had with breakfast that youput creamer in, and the yogurt
that actually had a lot of sugarin it, and then the pancakes
(17:33):
with the syrup that actually hada lot of sugar in it, by the
time you even leave the house inthe morning, most people have
had well over the recommendedamount of added sugar in their
diet already, and so when youput it down on paper, I think it
can really just be a goodexercise so that you can take a
look and understand okay, thisis what's happening, this is
(17:53):
what I'm presently doing and howcan I now make some changes to
this to better my health.
And it's not about cutting allthe sugar.
Like I said, it's aboutreducing the sugar, it's about
making swaps.
So maybe instead of having thecreamer in your coffee, maybe
you have just a splash of thecreamer, or maybe you decide,
(18:13):
you know what, I don't need thecreamer, I'm just going to have
plain milk, or, you know what,maybe I'll just have it black.
Making these small changes andsticking with them and then over
time it's going to add up andthat's really the focus of the
book and one of the goals that Ihave is to really just help
people kind of get on thatjourney.
Bettina M Brown (18:32):
And then you said you've also worked with
people going through things.
Is that where these like sevensteps came from, like as you're
seeing people trying to navigatetheir sugar consumption?
Dr. Nicole Avena (18:47):
Yes, and you know, one of the things I've
noticed over the years, for mostpeople who try to do this on
their own, is that it isoverwhelming, and, you know, a
lot of times people feel likethey're failing before they've
even started it, just becausethey don't know where to begin.
And so that's why I found that,you know, outlining these seven
steps was really just crucialfor people, because it enables
(19:12):
people to have a place to start,and one of the things that I
think unique about the plan isthat the steps are not linear,
meaning that you know, once youfinish the first step, you're on
to the second step, you can goback to the first step, and
that's, I think, the beauty ofyou know this plan is that it's
meant to be something that youcan do for your entire journey,
(19:37):
for the rest of your life.
It's not a diet book whereyou're going to, just, you know,
do this for six weeks so youcan lose 10 pounds, or whatever
the goal is.
This is about reevaluating yourrelationship with food, and
it's something that, if you wantto make these changes that are
going to benefit your health,it's got to be a commitment that
you're going to stick to, andso that's where I think the
(19:57):
steps can be really helpful,because it keeps people aligned
and it helps people to attackthis bit by bit and so it's not
so overwhelming.
Bettina M Brown (20:08):
Thank you for sharing that.
I have one last question foryou, because I hear this often
from my own patients, where theyhear things like yes, sugar is
addicting, and we hear fromother drugs.
You know it takes one time andyou can form neuro pathways and
you're addicted.
How long will it take to becomeunaddicted to sugar if this is
(20:34):
really where you've been raisedwith the fat-free cookies and
here we are today, or is thatjust a change for the rest of
your life that you have to do?
Dr. Nicole Avena (20:46):
Well, you know , I think the thing about sugar
is that we which is unlike allthe other things that we get
addicted to we are biologicallyprogrammed to want sugar.
From an evolutionary standpoint, sugar has been coded as being
safe, and sweet things areusually good for us.
So if you think about ourhunter and gatherer ancestors,
(21:10):
if they stumbled upon a berry,bush, the berries that are ripe
and healthy are going to be thesweet ones, so those are the
ones you want to eat, but theberries that are sour, that are
rotten, are going to be on thefloor of the forest and you
don't want to eat those.
Even breast milk, if you thinkabout it.
You know baby's first food issweet.
Breast milk has sweetness to it, and baby formula obviously has
(21:32):
sweetness to it, and so,typically, you know, sugar is
safe from an evolutionarystandpoint, but the problem is
that our brains have not caughtup with our present food
environment, and now sugar iseverywhere and it's added to so
many things.
We have so many man-madeprocessed foods that are not
(21:52):
good for us.
Just because it's sweet doesn'tmean it's safe anymore, and I
think that's the problem that weall struggle with in terms of
breaking this addiction, becausewe're all at risk because of
this inherent biological driveto have sweetness.
So I think, in terms of howlong is it going to last?
In terms of breaking theaddiction, I think that for most
(22:14):
people, what they find is that,you know, once they're able to
work through the seven steps andreally just get a better handle
on their diet and have thetools in place, it's something
that they can easily sustain.
But I think that all of us arestill at risk always, and that's
why we need to be cognizant andmindful that you know we can
(22:36):
fall back into this trap ofbinging and craving and
withdrawal, and we just need tobe aware, you know that sugar is
out there and we got to makesure that we're staying in
control of it and we can't getback to the point where it's
controlling us.
Bettina M Brown (22:51):
As a physical therapist for quite a few moons
now, I have just decided to takethe opinion that your body is
your gift, and how you choose tonourish it and use it so far as
hiking, biking, walking, havinga good time with friends what
you choose to do with thatreally is a reflection of what
(23:13):
you value.
It is also a reflection of whatwe know and the information
keeps changing and it is ourresponsibility to take care of
this gift, because one thing Ido see is when we don't have the
full use of that gift, itreally affects our life deeply,
and so I encourage you to learnand make your own opinion, make
(23:36):
your own informed opinion,knowing half of what you're
dealing with is your own biology, right.
So I thank you so much forlistening to this.
Go ahead and email me.
If you have any ideas or youwould like to further this
discussion at Bettina atintherisingcom, go ahead, hit
subscribe.
It does so much for thischannel and please leave a
review.
I thank you for your time andlet's keep building one another
(24:00):
up.
Dr. Nicole Avena (26:20):
You, you, you, you the you, you, the, you, you
(29:08):
you.
Hello and welcome to In the Rising a
health and wellness podcast forthose going through and those
supporting those going throughcancer.
My name is Bettina Brown andI'm board certified in physical
therapy, wound care andlymphedema.
And you know, for me cancer isvery personal.
It's affected my friends, myimmediate and my not so
(00:26):
immediate family, and thereforeI created this podcast and fit
after breast cancercom toaddress the multiple dimensions
of our lives during and afterrecovery.
Hello, hello and welcome to Inthe Rising podcast Today.
(00:48):
I'm really excited to introduceto you Dr Nicole Avena, food
sugar addiction expert, becauseshe has a PhD in it from
Princeton and has spent over 20years looking into this, helping
us learn how to navigate ournutrition.
Nutrition and how reallynutrition is medicine.
(01:08):
So I'm really excited for youto listen today.
Good morning, good morning, drNicole Avena.
How are you doing today?
I am great, it's nice to bewith you, thank you.
Likewise, I've read about you.
I've read your new book,sugarless, and what I'm really
fascinated about you is thatthis is a topic that is a part
(01:32):
of your life.
This is a huge journey for you.
Can you share a little bitabout your background?
Dr. Nicole Avena (01:37):
Yeah.
So it's interesting, I cameinto this field in a very, I
guess, sort of unique way.
I've never, luckily, had anyissues with eating disorder or
my health related to diet.
I actually came into thisbecause I was starting my PhD at
Princeton in neuroscience and Iwas talking with my advisor
(02:02):
about what kind of project Imight work on for my
dissertation, which is this huge, massive, five-year-long
project.
And one of the things that westarted talking about and this
is going back to the year 2000,2001, was that at the time a lot
of people were struggling withobesity and we were hearing more
about it in the media.
(02:22):
But the idea was that it's theirfault, it's a moral failing,
they don't have willpower.
And we started to think well,maybe there's something more to
this.
Maybe the highly processedfoods that have tons of added
sugar that are really justeverywhere these days are doing
something to people and it'smaybe making them addicted.
(02:42):
And just like people getaddicted to drugs or alcohol,
maybe some people could getaddicted to sugar and that could
be why it's so hard for peopleto eat healthy.
And so that kind of led me downthis journey that I've been on
ever since of studying whetheror not sugar could be addictive,
and from there I have beenstudying how sugar affects our
(03:03):
overall health, how it affectsour mental health, and what
we've learned has just beenfascinating, and there's just so
much research now that's beenpublished on this topic and it's
just something that's reallybeen near and dear to my heart.
Bettina M Brown (03:19):
Well, thank you for sharing that.
And when I was reading aboutyou, you were talking about your
graduate work on rats and therewas this one line and you said
rats and mice have similarneural circuitry to humans and I
laughed out like literallylaughed out loud because I
thought, wow, this is a эта Sadand good at the same time.
(03:42):
But what you also mentioned isthat the rats also developed
some, some tendencies that Ifelt Connected to, and I don't
have the word out in front of me, but there was a resistance to
extinction, like when the lightbulb was out, sugar was not
available, but they still wentto it.
Can you share a little bit moreabout what you've noticed about
(04:03):
that sort of mental habit?
Dr. Nicole Avena (04:06):
Yes, and I think that you know these
studies that we, you know,initially conducted in our
little lab rats.
In many ways, you know, itreminds me of what happens to
humans.
And so in our lab rats what wefound is that if they're used to
pressing a lever to get sugarright, then all of a sudden one
day the lever doesn't work, thelight bulb isn't on.
That signals the sugarsavailable.
(04:27):
Their resistance to extinctionemerges in the sense that
they're not going to extinguishthat response.
They're not going to justrationally stop pressing the
lever right.
If you know that there is, youknow, no sugar available, the
lights not on, the bar is notgoing to give you anything to
drink, then there's no sense inpressing the lever.
But what ends up happening?
(04:48):
If you're really cravingsomething, then they're going to
keep on pressing that lever.
And that's what we see in ourlaboratory rats and we also see
that in our people when youthink about it.
I mean, if you know there's noDessert in your refrigerator,
but you just open it up anywayand stare off into it, and you
know.
It's again something that Ithink we can see happening on
(05:12):
the human level in many caseswhere people are craving sugar
and it really does, I think,speak to how Powerful those
cravings can be and why it canbe difficult for a lot of people
to not give into them when theydo occur.
Bettina M Brown (05:27):
Yeah, and you also describe in the book that
we kind of gave ourselves someof this problem by trying to
eliminate another problem,trying to eliminate fats.
Can you share a little bit likehow did we end up here?
Dr. Nicole Avena (05:42):
Yeah.
So I think this is reallyinteresting because it's kind of
part of the social history ofOur food environment, which I
think is really just fascinatingbecause there's so much
psychology in it.
So what really happened forthose that can remember back
during this time, who were alive, you know, back in you know the
1980s and 90s, we reallystarted to see this big push
(06:07):
toward Minimizing fat and therewas this very big media push and
medical community push toreduce fat in your diet, because
fat had been linked tocardiovascular disease and so
fat became demonized.
And I remember being a kid andyou know my mom Would try to be
(06:27):
healthy, so she would go to thestore and buy these cookies that
were fat-free cookies and itwas literally like a license to
be able to eat as many as youwant because they were fat-free,
so they're good for you.
The problem was that when youtake the fat out of food
products, you don't really havemuch flavor, and so in order to
make them taste good, you got toput some sugar in.
(06:49):
So all these fat-free productswere loaded with sugar and other
carbohydrates and so, althoughwe were good about getting away
from fat, we inadvertently endedup getting hooked on sugar as a
society.
And so now what we're seeing isthe effects of that in terms of
, you know, rising obesity ratesobesity, you know, being so
(07:12):
pervasive across the country andAlso all of these medical
complications that can comealong with eating too much added
sugar.
You know, it's not justoverweight or being obese, it's
cardiovascular disease, it'sdiabetes, it's fatty liver
disease and, on top of that,it's also mental health issues
that can arise as a result oftoo much sugar.
(07:34):
So it did start off by, likeyou said, you know, trying to
fix something that was a ryewhere, you know, yeah, fat
wasn't good for our heart, butin the end, I think we often
really do more damage than wedid help, because it's something
that we basically just replaced, you know, one bad thing with
another.
Bettina M Brown (07:55):
Absolutely, and I think, ultimately, the quest
is always to find this health.
But everything has a varietyfor a reason.
I think that's what we'recoming about and, as I've done
some of my own research, ouraddiction makes people money.
Also, there's food companiesthat literally will Take chips
(08:17):
and Find out what is the rightamount of crisp that makes us
have a little dopamine hit right.
So we are creating, we are ourattention, our food choices are
really Benefiting some people.
So I think some people aremotivated by wanting to be
healthy, some people aremotivated by anger and some
people are more by fear.
(08:37):
So Whatever it takes to reallychange that.
You also shared this one thingthat rats preferred the sugar
over cocaine, and I think that'ssomething to to really take a
moment and pause about.
Can you describe that?
Dr. Nicole Avena (08:54):
Yes, I think this is one of the more popular
studies that's been discussed,because it is really, I think,
alarming when you think about it.
And so, in this study, ratswere offered a choice between
sugar, water or cocaine, andthey overwhelmingly decided that
they would rather have sugar.
(09:14):
And so, again, you know, weknow that cocaine is a very
powerful addictive drug, and thefact that rats are willing to
consume sugar in place of it tome is really telling in terms of
how powerful sugar is and howit can affect the brain.
And I think that it isinteresting too from the
(09:35):
standpoint of, you know, we allknow that cocaine's not good for
you and you shouldn't use it,but in our modern society, I
mean, we really do notdiscourage sugar use.
It's celebrated.
I have little kids, and so I seethis in the schools all the
time, where you know everybodygets a lollipop or everyone's
(09:56):
getting candy, or you know it'ssomething that's really heavily
promoted, especially among youngpeople, as you know, being a
socially acceptable, normalthing.
And I think that that makesthis all the more dangerous
because what we're findingthat's happening is that, over
time, yeah, kids might, you know, be healthy when they're young,
(10:17):
but if we're in training themto be addicted to sugar when
they're five or six years old,then what's that gonna mean for
their health when they get olderand those habits are gonna be
really difficult to break.
Bettina M Brown (10:30):
Absolutely, and thanks for pointing that out
about how we're training.
You know our kiddos and I willshare that my I'm a mom as well
and when my son was young, Iwould try to take the lollipop
and say, let's save that foranother time, let's have some
carrots or this.
And I remember this one timethat he just said I want sugar,
(10:51):
and it made me pause.
I literally stopped moving andI thought, wow, this is this
process already unfolding,because that's what they get a
snacks at school and a reward.
Dr. Nicole Avena (11:04):
Yes, and I think that's something that,
over time, we just need tochange.
I think, you know, 50 years agoit was fine, you know, for the
teacher to give out candybecause that might be the only
sweet thing that the kid had allday, but now, I mean, it's just
one of the you know 99 sweettreats the kids are having
(11:27):
throughout the day.
So I think it's reallysomething that we need to
revisit in terms of rewardingour kids for their good behavior
.
And, you know, we have to keepin mind, if we know that this is
bad for their health, it's nota reward, If anything, it's a
punishment.
And so we need to just, I thinkyou know, make some changes
around that socially so that wecan, you know, help our kids to
(11:49):
get on a good track for goodhealth as they get older.
Bettina M Brown (12:01):
Absolutely.
And, Dr Avina, you've mentioneda few times sugar and mental
health.
Can you expand on that a littlebit?
Dr. Nicole Avena (12:08):
You know, this is one of the things that I
found to be surprising.
I wasn't really expecting thisto be one of the outcomes of
cutting back on added sugar, but, overwhelmingly, when people
that I work with or talk withwho have been able to reduce the
amount of sugar in their dietand get away from it, will
report that they're surprised athow it affected their mood and
(12:32):
how it made them feel so muchbetter and how they felt clarity
of thought, how they didn'thave that brain fog anymore.
And I think, from the biologicalstandpoint, it comes down to
the fact that sugar is highlyinflammatory and when people are
consuming it in excess, it'sgonna have an inflammatory
response, and that can happen inour brain.
(12:53):
And so when we're able toremove sugar and reduce it, it
really does help our brain toheal and, as a result, we're
going to see things like youknow improved mood.
We're gonna see things like youknow, not having achy joints
all the time and we're gonna see, you know, these other
unexpected but yet pleasantconsequences of cutting back on
(13:17):
the added sugar.
And I think for the mentalhealth piece especially.
I mean we hear so much aboutmental health these days and how
many people are struggling withmental health issues, and I
think for all of us, it's in ourbest interest to look at our
diet when we think about ourmental health, because that's
something that you can easilychange, and if it's gonna
(13:38):
improve your mood and help youfeel better, then why not?
It's something that I think weall could benefit from.
Bettina M Brown (13:46):
Yes, yes, and you know, with lots of
inflammation come along otherissues, like you even mentioned
the joints.
What about this other topic?
And then we're gonna go intothe second part of your book
about obesity and sugar.
I feel like there are sometimes, just when I look at it as a
(14:07):
regular person, like well, can Ihave some sugar?
Can I not have some sugar?
Are they hiding sugar in otherplaces?
And then is this going to makeme fat?
Dr. Nicole Avena (14:18):
Yeah, I think that it boils down to your
relationship with sugar andwhether or not you're in control
, and I think that's really thegoal of my book sugar list is to
help people to get the controlback, because for many people
who are addicted to sugar, thesugar is in control right.
The sugar is telling them Iwant you to eat more of me, I
(14:39):
want you're going to havewithdrawal, you're going to have
to crave me, and that's not howit's supposed to be.
And so it's really aboutgetting to the point where you
can enjoy sweet treats and beable to say, okay, I've had
enough, I've had one piece andthat's all I need to feel good
or to enjoy myself.
And so it's not about reallyjust completely cutting
(15:00):
everything out.
I don't think that'ssustainable, I don't think it's
possible and I don't think it'snecessary.
I think it's more about gettingcontrol back, and I think, when
it comes to our diet andobesity, I think for many people
, yes, that is something thatthey're concerned about.
If people are trying to loseweight or want to have a healthy
body weight, cutting out sugarcan be one of the easiest ways
(15:24):
to do that to reduce your bodyweight, and starting with
beverages, I think, is reallythe spot to start, because a lot
of our beverages are loadedwith added sugar, and it's not
just sodas and juices, which weshould avoid, because those are
really just empty calories andloaded with added sugars that
are going to provide nothing butexcess body weight to us.
(15:45):
It's even the coffee drinks.
This has become.
One of the things that I'vebeen noticing a lot more and
more is that you go to a coffeeshop these days and basically
it's a dessert.
I don't even know if it'scoffee anymore.
It's so much sugar in it.
I think there's more sugar thanthere is coffee in the products
.
So it's really about, I think,just revising your relationship
(16:07):
with sugar and making sure thatyou're in control, and that's
what I walk people through inthe book with the different
seven step plan that I offer forpeople to just get control back
.
Bettina M Brown (16:18):
Absolutely, and it's sugarless a seven step
plan to uncover hidden sugarsand curb your cravings and
conquer your addiction, and oneof your steps is to do a three
day food diary to actually knowwhat you're eating.
From many people that I've hada conversation with, this is
almost like the most difficultpart is to really do this food
(16:39):
diary.
Do you feel that it's kind ofhard to face what you're eating
because it's three days of justwriting some things down, or do
we have shame with what we'reeating?
Dr. Nicole Avena (16:51):
Well, I really try to encourage people, when
they do this important step, tonot feel shamed, not to reflect
on themselves like oh my gosh, Ican't believe I'm eating all
this stuff, or look at thesetwins.
It's about getting a realisticpicture of what you're actually
eating on a day to day basis,and I think for a lot of us, you
(17:11):
don't realize it until you putit down and writing and are able
to see how little bits of sugarhere and there become sugar
everywhere.
And when you add it up and yousee how okay, the coffee that
you had with breakfast that youput creamer in, and the yogurt
that actually had a lot of sugarin it, and then the pancakes
(17:33):
with the syrup that actually hada lot of sugar in it, by the
time you even leave the house inthe morning, most people have
had well over the recommendedamount of added sugar in their
diet already, and so when youput it down on paper, I think it
can really just be a goodexercise so that you can take a
look and understand okay, thisis what's happening, this is
(17:53):
what I'm presently doing and howcan I now make some changes to
this to better my health.
And it's not about cutting allthe sugar.
Like I said, it's aboutreducing the sugar, it's about
making swaps.
So maybe instead of having thecreamer in your coffee, maybe
you have just a splash of thecreamer, or maybe you decide,
(18:13):
you know what, I don't need thecreamer, I'm just going to have
plain milk, or, you know what,maybe I'll just have it black.
Making these small changes andsticking with them and then over
time it's going to add up andthat's really the focus of the
book and one of the goals that Ihave is to really just help
people kind of get on thatjourney.
Bettina M Brown (18:32):
And then you said you've also worked with
people going through things.
Is that where these like sevensteps came from, like as you're
seeing people trying to navigatetheir sugar consumption?
Dr. Nicole Avena (18:47):
Yes, and you know, one of the things I've
noticed over the years, for mostpeople who try to do this on
their own, is that it isoverwhelming, and, you know, a
lot of times people feel likethey're failing before they've
even started it, just becausethey don't know where to begin.
And so that's why I found that,you know, outlining these seven
steps was really just crucialfor people, because it enables
(19:12):
people to have a place to start,and one of the things that I
think unique about the plan isthat the steps are not linear,
meaning that you know, once youfinish the first step, you're on
to the second step, you can goback to the first step, and
that's, I think, the beauty ofyou know this plan is that it's
meant to be something that youcan do for your entire journey,
(19:37):
for the rest of your life.
It's not a diet book whereyou're going to, just, you know,
do this for six weeks so youcan lose 10 pounds, or whatever
the goal is.
This is about reevaluating yourrelationship with food, and
it's something that, if you wantto make these changes that are
going to benefit your health,it's got to be a commitment that
you're going to stick to, andso that's where I think the
(19:57):
steps can be really helpful,because it keeps people aligned
and it helps people to attackthis bit by bit and so it's not
so overwhelming.
Bettina M Brown (20:08):
Thank you for sharing that.
I have one last question foryou, because I hear this often
from my own patients, where theyhear things like yes, sugar is
addicting, and we hear fromother drugs.
You know it takes one time andyou can form neuro pathways and
you're addicted.
How long will it take to becomeunaddicted to sugar if this is
(20:34):
really where you've been raisedwith the fat-free cookies and
here we are today, or is thatjust a change for the rest of
your life that you have to do?
Dr. Nicole Avena (20:46):
Well, you know , I think the thing about sugar
is that we which is unlike allthe other things that we get
addicted to we are biologicallyprogrammed to want sugar.
From an evolutionary standpoint, sugar has been coded as being
safe, and sweet things areusually good for us.
So if you think about ourhunter and gatherer ancestors,
(21:10):
if they stumbled upon a berry,bush, the berries that are ripe
and healthy are going to be thesweet ones, so those are the
ones you want to eat, but theberries that are sour, that are
rotten, are going to be on thefloor of the forest and you
don't want to eat those.
Even breast milk, if you thinkabout it.
You know baby's first food issweet.
Breast milk has sweetness to it, and baby formula obviously has
(21:32):
sweetness to it, and so,typically, you know, sugar is
safe from an evolutionarystandpoint, but the problem is
that our brains have not caughtup with our present food
environment, and now sugar iseverywhere and it's added to so
many things.
We have so many man-madeprocessed foods that are not
(21:52):
good for us.
Just because it's sweet doesn'tmean it's safe anymore, and I
think that's the problem that weall struggle with in terms of
breaking this addiction, becausewe're all at risk because of
this inherent biological driveto have sweetness.
So I think, in terms of howlong is it going to last?
In terms of breaking theaddiction, I think that for most
(22:14):
people, what they find is that,you know, once they're able to
work through the seven steps andreally just get a better handle
on their diet and have thetools in place, it's something
that they can easily sustain.
But I think that all of us arestill at risk always, and that's
why we need to be cognizant andmindful that you know we can
(22:36):
fall back into this trap ofbinging and craving and
withdrawal, and we just need tobe aware, you know that sugar is
out there and we got to makesure that we're staying in
control of it and we can't getback to the point where it's
controlling us.
Bettina M Brown (22:51):
As a physical therapist for quite a few moons
now, I have just decided to takethe opinion that your body is
your gift, and how you choose tonourish it and use it so far as
hiking, biking, walking, havinga good time with friends what
you choose to do with thatreally is a reflection of what
(23:13):
you value.
It is also a reflection of whatwe know and the information
keeps changing and it is ourresponsibility to take care of
this gift, because one thing Ido see is when we don't have the
full use of that gift, itreally affects our life deeply,
and so I encourage you to learnand make your own opinion, make
(23:36):
your own informed opinion,knowing half of what you're
dealing with is your own biology, right.
So I thank you so much forlistening to this.
Go ahead and email me.
If you have any ideas or youwould like to further this
discussion at Bettina atintherisingcom, go ahead, hit
subscribe.
It does so much for thischannel and please leave a
review.
I thank you for your time andlet's keep building one another
(24:00):
up.
Dr. Nicole Avena (26:20):
You, you, you, you the you, you, the, you, you
(29:08):
you.
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