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Dysfunctional Foods: How the Contemporary American Food System Creates Imbalanced Bodies, Minds and Behaviors Margaret Adamek, University of MN Class of 1989 February 9, 2005 How many of you know someone… Who has struggled with alcoholism? Who suffers from depression or anxiety? Who has chronic issues with their weight or struggles with eating disorders? Who has a child with hyperactivity or attention deficit issues? Who has been diagnosed with diabetes? Who has a family with one or more of these issues? solving weight issues Standard Approach: Individual Responsibility Cut calories Increase activity Reduce soft drink and fast food consumption Reduce time spent watching television and playing video games Why doesn’t this work? Sugars (sweeteners and refined carbohydrates) have a drug effect on the brain Sugars cause the body to release its own opiates (beta endorphin) Sugars act on the same neurotransmitter system as alcohol, morphine and heroin You have a population in a constant state of withdrawal, craving and relapse from branches to roots: the effects of diet on people Alcoholism Obesity Depression Root Cause Anxiety Diabetes ADHD Eating Disorders …..the unraveling web caffeine sugar & amphetamine neurochemical roots of the problem Volatile blood sugar Low serotonin Low beta endorphin Low dopamine Glucose molecule Volatile blood sugar Tired all the time for little reason Restless and edgy Confused/foggy/space y Irritable and easily frustrated Cranky Short-fused Low serotonin Depressed Impulsive Short attention span Scattered Aggressive Reactive Craving sweets and carbohydrates Serotonin peptide Low beta endorphin Low pain tolerance Low self-esteem and feels inadequate Tearful Sensitive to criticism Feels isolated Seeks crisis Feels victimized Craves sugar and fat Beta endorphin peptide Low dopamine Correlated with unhappiness Linked to aggressive behavior and violence Lack of ‘positive emotionality’ Protein intake positively influences dopamine production dopamine peptide Restoring health, land and food Dietary change is very difficult, even when more healthful options are available The ‘addicted body’ must be stabilized to assist in the rejection of the contemporary diet As the land and diet are brought into balance, so too must the body Theory of Sugar Sensitivity Kathleen DesMaisons, Ph.D DBA/C57 mice – inherited suite of biochemical deficits that give rise to a set of emotional and physical symptoms Individuals who suffer from this profile seek out foods or substances that elevate these deficits… Sugar, fat, alcohol and other drugs cause the brain to produce opiates C57 DBA Sugar Sensitive Eating Habits Skip breakfast Low protein intake Erratic mealtimes High intake of refined carbohydrates and sugars Frequent meal skipping High consumption of caffeine True of alcoholics and of ‘C57’ sugar sensitive types Research Base Sugar and alcohol evokes beta endorphin (Gianoulakis 1994, 1996; Blass 1991, 1995) Low serotonin, carbohydrate craving, obesity and depression (Wurtman 1986, 1995) Fat consumption and beta endorphin release (Drewnoski 1983, 1987, 1992) Serotonin, and relationship to fat and sugar intake (Fernstrom 1971, 1986, 1987, 1995) More Research Sugar induces physical dependency (Colantuoni and Hoebel 2002) Sugar is a ‘gateway’ substance that increases likelihood of addiction to other substances, e.g. amphetamines (Hoebel 2003) Sugar creates endogenous beta endorphin response (Schoenbaum 1989) Sugar and fat together create significantly increased consumption behavior (Kelley 2003) More research… Palatability/sweet taste alone will evoke opiate response (Hoebel) High fructose corn syrup does not metabolize in ways that other sugars do, creating biochemical reactions that alter metabolism (Bray 2003) Further research…. Too much fructose alters metabolism (Teff, 2004) One serving of soft drink per day increases a women’s chances of Type II diabetes by 85% (Schulze, 2004) …and yet more!! Addiction mechanism in the rat is similar to humans (Deroche-Gamonet et al., 2004) Areas in brain activated in food craving are also activated in drug craving (Raglund et al 2004) what do you get? Steps toward Stability Kathleen DesMaisons, Ph.D. 1. 2. Eat breakfast everyday – within one hour of waking; adequate protein; complex carbohydrates Journal what and when you eat/how you physically and emotionally feel Steps toward Stability Kathleen DesMaisons, Ph.D. 3. 4. Eat three meals a day – spaced 5 – 6 hours apart; adequate protein, complex carbohydrates and vegetables; move sugar consumption to meals Vitamins and Nightly Potato – vitamin C (free radical scavenger); Bcomplex – aids in detoxification and restoration; zinc; omega 3 fatty acids//potato for serotonin synthesis Steps toward Stability 5. 6. Whites to Browns – slowly move refined grains to whole grains Remove Sugars – slowly remove ‘overt’ and ‘covert’ sweeteners Steps Toward Stability 7. Stabilize – beta endorphin receptor increase and stabilization; explore food allergy issues; adequate fatty acids consumption; increase insulin receptor sites to heal insulin resistance Effects of diet Regulates blood sugar – no dips and spikes Elevates serotonin Able to say ‘no’ and no impulsive behavior Increases beta endorphin No ‘sleepies;’ less irritability; not moody Secure sense of self; strong self-esteem and self-acceptance Increases dopamine Less aggressive, diminished violence and anger How do you feel? Consistent, steady energy without fits of fatigue or drowsiness Happy, upbeat, not feeling ‘done to’ Secure and relaxed – not anxious Productive and able to concentrate Compassionate and patient Good at self-care Beta endorphin Activating Opiates Skipping meals ‘Binge’ sugar dose Super Size Me – sugar and fat Compulsive exercise Stabilizing Opiates Regular mealtimes Adequate food for blood sugar Removal of excessive refined carbs No sugar on an empty stomach! Exercise & fun! What are we seeing? 92% long term success rate with alcoholism recovery Drastic improvement in depression, ADHD, OCD, ODD, anxiety, weight, selfesteem, diabetes Improved triglycerides, lipids, blood glucose levels, cholesterol Connecting the body to community How we produce food What we produce How we process food How we consume food What are the economic, ecological, cultural and health impacts? Healing the sacred web of life… Obesity: Where are we today? • 64% of U.S. adults are estimated obese or overweight (NHANES 1999-2000) •31 % of Americans are estimated obese - (NHANES National Health and Nutrition Examination Survey 1999–2000) • 106% increase in obesity nationwide since 1981 (French et al. 2001) • 5 – 7% increase in obesity each year (CDC) • All but one state has 15% or greater rate of population as overweight (CDC) • 58% of Minnesotans are Obesity Trends* Among U.S. Adults BRFSS, 1991-2002 (*BMI ≥30, or ~ 30 lbs overweight for 5’ 4” woman) 1991 1995 2002 No Data <10% 10%–14% 15%–19% 20%–24% ≥25% Diabetes – where are we now? 70% of diagnosed Type II diabetes is attributable to obesity (NIDDK – NIH) 6.3% of American population is diabetic (NIDDK-NIH) 6% increase in diabetes per year (NIDDK-NIH) Between 1990 -1998, prevalence of diagnosed diabetes increased 33% (CDC 2002) Diabetes and Gestational Diabetes Trends Among Adults in the U.S., BRFSS 1990, 1995 and 2000 1990 1995 2000 Source: Mokdad et al., Diabetes Care 2000;23:1278-83; J Am Med Assoc 2001;286(10). Depression & anxiety today 9.5% of American adults suffers from depression each year (National Institutes of Mental Health - NIH Publication No. 01-4584 ) 13.3% of American adults suffer from anxiety disorders (National Institutes of Mental Health - NIH Publication No. 01-4584 ) Attention deficit/ hyperactivity disorder 7.5% of children exhibit this disorder; 3 times as many boys as girls (data taken from Minnesota; Archives of Pediatrics and Adolescent Medicine 2002) 80% of prescriptions for amphetamines are written for children diagnosed with ADHD (DEA Congressional Testimony, 2000) Administration of amphetamines to children has risen 3000% in the last ten years (DEA Congressional Testimony, 2000) Alcoholism More than 50% of American adults have a close relative who has/had a drinking problem (Dawson 1998) 7.4% of American adults are dependent or abuse alcohol in 2000 (Grant 1994) 20% of individuals seeking primary healthcare are alcoholic (Bellas, Rand Corporation, 2000) 6.3% of adult Minnesotans report chronic drinking (NIAAA 1984-2002) 90% of alcoholics are likely to experience at least one relapse during the four years after treatment (NIAAA 1989) Economic Impact - Obesity $78.5 billion in healthcare costs for obesity (National Health Accounts, CDC) 7% of US healthcare costs are obesity-related (French, 2003) $1.307 billion in healthcare costs for Minnesota (CDC) Obesity-related disability claims up 130% between 1984 and 1996 for ages 30 – 49 (Rand ) Corporation By 2020, 20% of healthcare expenditures would be for obesity-related issues. Economic Impact - Obesity Obesity is associated with a 36% increase in inpatient and outpatient spending Obesity is associated with a 77% increase in medications (Sturm 2002 Economic impact – depression/anxiety/alcoholism Cost of depression is $83.1 billion (Greenberg et al. 2003) For diabetes….$98 billion per year (premature mortality, disability, healthcare costs, workloss) For alcoholism, estimated productivity loss is $134.2 billion (NIAAA 2001) Alcohol-related illness costs $87.6 billion; premature death $36.5 billion (NIAAA 2001) For alcoholism, estimated cost of alcohol abuse is $185 billion for 1998 (NIAAA 2001) impact on our children 27% of children are overweight (Centers for Disease Control) Obesity rates among children have doubled in the last ten years and tripled for adolescents (Troiano, 1998) Children born in the year 2000 have a 33% chance of becoming diabetic if they’re boys; 39% if they’re girls (Venkat Narayan et al, 2004) Childhood tantrums are positively correlated with obesity (Agras et al. 2004) How do these public health issues relate to diet? Eating Disorders Diabetes Public Health Alcoholism Obesity Crisis ADHD Depression Change in Carbohydrate Consumption Increase of 50% in refined carbohydrates from 1970 (USDA Economic Research Service) Americans consume less than one serving per day of whole grains (USDA Economic Research Service) 4000+% increase in consumption per annum per person of high fructose corn syrup (USDA Economic Research Service) Additional average 300 daily calories consumed attributed to increase in carbohydrate consumption (CDC 2004) U.S. Sugar Intake Sugar intake rose 30 percent between 1983 and 1999 and was at 158 pounds per person/year (Center for Science in Public Interest – 222.cspinet.org/new/sugar_limit.html) supply and utilization, with quantity, per capita co value of sugar use Supply and utilization D Candy and Other Confectionary Products: US Per Capita Consumption, 1966 – 2000, Pounds/ Year 30 25 20 15 10 5 2000 1995 1990 1985 1980 1975 1970 Year 0 2000 3/ 1997 1994 1992 1987 1989 Year 1984 1982 1979 1977 1974 1972 1969 1967 160.0 150.0 140.0 130.0 120.0 110.0 100.0 90.0 80.0 1964 Lbs Per Capita Consumption of Wheat Flour 1965 - 2001 US Per Capita High Fructose Utilization Corn Syrup Disappearance 05-Mar-2002 Food disappearance2 1967 – 2000, Pounds / Year 70 60 50 40 30 20 10 19 69 19 73 19 77 19 81 19 85 19 89 19 93 19 97 Y ea r 0 Number of Large-Size Portions Introduced Introduction of new, larger portions, 1970–1999. 70 60 50 40 30 20 10 0 1970-74 Young & Nestle 2002 1975-59 1980-84 1985-89 Year 1990-1994 1995-99 Portion sizes Energy dense, nutrient poor foods comprise 27% of diet (+ 4% alcohol) (Kant 2000) Standard portion size for factory-made cookies exceeds USDA standards by 700%; muffins by 333%, and bagels by 195% French fries, hamburgers and sodas increased 2 – 5 times since 1970 7-11 Big Gulp contains the caloric equivalent of more than one third the energy requirement of large segments of American population (Young and Nestle 2002) Media Attention The Sunday Telegraph – UK – Food Industry has known for years that foods high in fat and sugar impact consumption (August 2003) Atlanta Constitution – “Sugar Nation” Series (November 2002) New York Times Sunday Magazine – “What if It’s All Been a Big, Fat Lie?” (July 2002) World Health Organization – “Diet, Nutrition and the Prevention of Chronic Diseases” (February 2003) Our love affair with fast food One in four adults eats fast food everyday in the United States One in three children eats fast food everyday in the United States Soft drink consumption up 135% since 1977 Average number of soft drink servings per day climbed from 1.96 in 1977 to 2.39 in 2001 Policy Attention Soda machines and fast food removed from schools Federal funding for fresh fruits and vegetables in school lunches Support for physical and nutrition education in school and community contexts Political Pressure Suppression of WHO information and federal recommendations on reduction of refined carbohydrates Congressional movement to ban litigation against fast food corporations A complex system of addiction …with complex consequences The Sugar Project Healing culture from the molecular to the social Mending the sacred web of life Generating wellness creation, NOT wealth creation ecology economy culture public health community Sugar Project Mission to restore individual, community, ecological and social wellbeing through health-creating diets… Sugar Project Approach Ecologically restorative food production Economic development through enterprises related to healing (new food products, etc.) that encourage strong, local economies Low cost dietary intervention that improves public health outcomes a complex system of change Economic development Healthcare Policy Child and Youth Nutrition Ecological renewal Agricultural Policy Re-emergence of local food systems and economies Restoration of community health Outcome Healthy Ecologies Healthy Economies Communities that thrive People who feel well Wellness from the inside out! Sugar Project Priorities Children – school hot breakfast & lunch; academics/behavior Indian Country – food sovereignty through addiction recovery and prevention Research – controlled studies on addicts, children and in Native American communities Education – development of materials, training & curricula for various audiences Media/Public Policy – use of popular media to develop and influence policy agenda Partner Efforts New cropping system in Upper Midwest Economic development to encourage local food systems University research on brain biochemistry, diet, addiction and public health Generating new collaborations with entities as we move forward… amphetamine drug-free sugar & caffeine mending the web of life What can I do right now? Personally…. Read DesMaisons’ material and start the process Try eating breakfast with protein & carbs for a few days to notice the difference Potato Experiment Transition away from corn syrup Politically…. Explore opportunities for changing food options in dining service Explore ways to change school hot breakfast and lunch options in Northfield Identify different research questions tied to these issues For further information www.radiantrecovery.com or [email protected] “Sugar Addict’s Recovery Program,” by Kathleen DesMaisons The Sugar Project, Maggi Adamek University of Minnesota [email protected] 612-624-7451 Sources Obesity and related healthcare costs statistics: http://www.cdc.gov/nccdphp/dnpa/obesity/economic_con sequences.htm#National%20Estimated%20Cost%20of% 20Obesity http://www.rand.org/publications/RB/RB9043/ http://nutrition.about.com/library/weekly/aa010503a.htm Troiano, Richard P., Flegal, Katherine M. (1998, March). Overweight children and adolescents: description, epidemiology, and demographics. Pediatrics, 101, 497504. Behavioral Risk Factor Surveillance System, 2001, unpublished data. National Center for Health Statistics, Centers for Disease Control and Prevention, U.S. Department of Health and Human Services. Sources (cont’d) http://www.diabetes.niddk.nih.gov/dm/pubs /statistics/index.htm http://www.niddk.nih.gov/health/nutrit/pubs /statobes.htm http://www.diabetes.niddk.nih.gov/dm/pubs /statistics/index.htm http://www.niddk.nih.gov/health/nutrit/pubs /statobes.htm Sources (cont’d) http://www.ajc.com/living/content/living/special/s ugar/18sugarsouth.html http://www.who.int/nut/documents/trs_916.pdf http://www.psychiatrist.com/issues/greenberg.pd f http://www.ers.usda.gov/publications/FoodRevie w/DEC2002/frvol25i3a.pdf http://www.psychiatrist.com/pcc/pccpdf/v03n06/v 03n0611.pdf http://www.niaaa.nih.gov/databases/abdep2.htm http://www.rand.org/publications/MR/MR1280/mr 1280.ch2.pdf Sources (cont’d) http://www.nyu.edu/education/nutrition/PDFS/young-nestle.pdf http://www.nimh.nih.gov/publicat/numbers.cfm http://www.psychiatrist.com/pcc/pccpdf/v03n06/v03n0611.pdf Grant B.F., et al. Prevalence of DSM-IV alcohol abuse and dependence: United States, 1992. Alcohol Health & Research World 18(3):243-248, 1994. Dawson, D.A., & Grant, B.F. Family history of alcoholism and gender: Their combined effects on DSM-IV alcohol dependence and major depression. Journal of Studies on Alcohol 59(1):97-106, 1998. Harwood, H., et al. The Economic Costs of Alcohol and Drug Abuse in the United States, 1992. Rockville, MD: National Institute on Drug Abuse, 1998. http://www.naaso.org/news/19980902.asp Sturm, R. 2002. The effects of obesity, smoking, and drinking on medical problems and costs. Health Affairs. Centers for Disease Control (2002). Major increase in diabetes among adults occurred nationwide between 1990 and 1998. http://www.cdc.gov/nccdphp/dnpa/press/archive/diabetes_increase.htm Sources (cont’d) http://www.ajc.com/living/content/living/special/s ugar/18sugarsouth.html http://www.who.int/nut/documents/trs_916.pdf http://www.psychiatrist.com/issues/greenberg.pd f http://www.ers.usda.gov/publications/FoodRevie w/DEC2002/frvol25i3a.pdf http://www.psychiatrist.com/pcc/pccpdf/v03n06/v 03n0611.pdf http://www.niaaa.nih.gov/databases/abdep2.htm http://www.rand.org/publications/MR/MR1280/mr 1280.ch2.pdf Sources (cont’d) NIAAA (2001). Economic perspectives in alcoholism research. Alcohol Alert. http://wwww.niaaa.nih.gov/publications/aa51-text.htm NIAAA (1989). Relapse and craving. Alcohol Alert. http://www.niaaa.nih.gov/publications/aa06.htm Kant, A. (2000) Consumption of energy-dense, nutrient-poor foods by adult Americans: nutritional and health implications. The third National Health and Nutrition Examination Survey, 1988-1994. Am J Clin Nutr. 2000 Oct;72(4):929-36. Young, L. and Nestle, M. (2002) The contribution of expanding portion sizes to the US obesity epidemic. American Journal of Public Health. February; 92(2):246-249.