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COVID lockdown: stress and carb addiction

 

Dr. Tony Willis
Clinical Director for Diabetes, NWL Health and Care Partnership

Food

Panic buying. Empty flour shelves. #stress baking. #anxiety baking.

We’ve all seen the news headlines.

We’ve probably all experienced the longing to turn to comfort foods during the COVID lockdown

One of the most interesting things I’ve observed during the COVID crisis is the huge rise in demand for flour and home baking products.  The BBC recently ran an article in which they reported that grocery sales of flour were up by 92% and that the National Association of British and Irish Millers says the flour industry is “working around the clock”, milling 24 hours a day, seven days a week to meet demand. Flour and yeast are in short supply on supermarket shelves.

Morrisons supermarket baking section shelves empty with no flour

Coronavirus lockdown has led to a bread making and home baking boom, with Google Trends showing a massive rise in interest in bread and baking, and online recipe sites reporting a surge in interest for terms such as “sourdough starter” – BBC Food has seen a 540% increase in traffic to its banana bread recipe and an 875% increase in traffic to its basic bread recipe.

Graph showing a huge spike in Google searches for cake and bread recipes compared to searches for lettuce or fish recipes

Why is this?

Stress baking

The Guardian recently ran an article with the somewhat witty title “Kneading to relax? How coronavirus prompted a surge in stress baking.” Who doesn’t love a good pun?

The article outlines some of the benefits of small, creative projects and the calming effect that kneading, rolling and mixing can have on the emotions.

An article titled “Quarantine Baking in Times of Crisis” picks up on the theme of stress baking and anxiety baking to help get through the COVID crisis.

I wonder whether there’s more to it than just being creative or being mindful. Isn’t it interesting that searches for other foods or recipes like fish or lettuce haven’t seen the same surge?

So what happens in your body when you eat carbohydrates (“carbs”) and why does this relate to stress?

How sugar affects the brain

Nicole Avena, a research neuroscientist at the New York Obesity Research Center at Columbia University and an expert in the fields of nutrition, diet and food addiction.  Her TED education video is a fascinating explanation about how sugar affects the brain - I recommend watching it.

When you eat something containing sugar, your taste buds, brain and gut all wake up. Your brain’s reward system is activated in a way that’s similar to what happens when people use nicotine, alcohol or class A drugs.

Scan showing the effect of sugar and cocaine on the brain

This PET (positron emission tomography) scan shows the release of dopamine in the brain’s reward centres in response to sugar and cocaine.

A major role of dopamine is to create feelings of pleasure. When we consume large amounts of sugar in one go, dopamine receptors begin to down-regulate, therefore we have fewer dopamine regulators. This can easily result in a need to increase sugar intake in order to compensate for the lack of receptors and activate our reward system. This creates a vicious cycle of sugary addiction.

Maybe we’re naturally turning to carbs during the COVID crisis to create feelings of pleasure through the brain’s dopamine system?

Sometimes this isn’t a problem – I’m doing a spot of home bread making myself. Sometimes though, we can recognise that there’s a bit more of an issue, that we’ve become dependent on sugar and carbs.

How would you know if you’re addicted to carbs? Try this quiz on the Blood Sugar Diet website: https://thebloodsugardiet.com/quizzes/are-you-addicted-to-carbs/

Before we go on though, the point about this blog is not to create shame. As the shame researcher Brené Brown says:

“I don’t believe shame is helpful or productive. In fact, I think shame is much more likely to be the source of destructive, hurtful behaviour than the solution or cure.”

​What I hope to do to is inform and empower you towards making active decisions about your relationship with carbs one small step at a time...​

Carbs in Food

So you might be thinking “what’s the link between bread and sugar?”

Flour is around 72% carbohydrate, mostly starch, which is in effect a long chain of sugar molecules joined together. When you eat starchy foods (including bread, pasta, rice, potatoes, plantain or West African foods like fufu or garri), the starch gets broken down into glucose by an enzyme called amylase, which is released in saliva and from the pancreas.

A diagram showing the digestion of starch into gucose

The effect of starchy foods on blood sugar can be huge. For example, a plate of rice, depending on size, could have an effect on blood sugar equivalent to 18 teaspoons of sugar.

Diagram showing the effect of different portion sizes of rice on blood glucose levels

Two pitta breads contain the equivalent of 19 teaspoons of sugar once the starch breaks down.

The rise in blood sugar levels can cause problems for a number of reasons:

  1. if you have type 2 diabetes or non-diabetic hyperglycaemia (prediabetes), high blood sugar can increase the risk of diabetes complications. If you have type 1 diabetes, the challenge is in matching insulin to carb intake
  2. excess sugar blood is stored as fat, causing weight gain
  3. the result can be a cycle of blood sugar and mood swings

Blood Sugar Roller Coaster

Taking action

You may now be thinking that there are some things you’d like to change about your diet.

Here are some things that might help:

   1. Count your carb intake

Try counting your carb intake for one or more days, and try translating this into teaspoons of sugar using the information here or in the Carbs and Cals World Foods book. You might be surprised how easily the sugar cubes mount up.

Brown and white sugar, sugar cubes stacked on a pile of sugar

This can be quite a powerful exercise, and keeping a food diary even for just one day can be helpful if you overeat more than just carbs. I’ve done this with a few patients and the sugar cube pile can easily reach 50 or more in a single day.

Reducing carb intake can take you out of the cycle of sugar and mood swings.

Watch our series of videos on achieving remission from Type 2 diabetes to learn more or take a look at the page on Understanding carbohydrates to get further information.

We’ve put together 7 day lower-carb menu plans for vegetarians and non-vegetarians to help you get kick-started. You can also take a look at our advice about Healthy Eating on a Budget.

Note that if you have are on insulin or medication such as sulphonylureas (e.g. gliclazide) or meglitinides (e.g. repaglinide), you should speak to your doctor before making any changes to your carbohydrate intake as this could cause hypoglycaemia if your medication dose is not adjusted.

   2. Make some low carb baking “smart swaps”

These high fibre bread rolls could pass for the real thing, and contain the equivalent of less than half a teaspoon of sugar each. Or why not try these seed crackers? – I’ve tried them, they taste fantastic and have a great crunch to them.

   3. Increase your intake of pulses and vegetables that grow above the ground

By filling up on pulses and vegetables that grow above the ground (i.e. not root vegetables like potatoes, sweet potatoes, or yams), you’ll quickly find that there’s less space for sugary or carb-heavy foods.

Raw healthy food clean eating vegetables and grain products: green vegetables, quinoa, chickpea, beans, buckwheat, green lentils on dark stone background

   4. Eating enough protein and healthy fats

Your weight is regulated by your brain, particularly an area called the hypothalamus. In order for your brain to decide how much to eat and when it listens to signals from your body.

Some of the most important signals it listens to are hormones, released in response to eating. Higher protein intake increases levels of the satiety (appetite-reducing) hormones GLP-1, peptide YY and cholecystokinin while reducing your levels of the hunger hormone ghrelin.

By eating more protein and fewer carbs, you reduce the hunger hormone (ghrelin) and boost several satiety hormones including GLP-1 (Glucagon-Like Peptide 1). This can help in losing weight. Watch the video to understand more, or read about how your appetite is controlled here:

Sources of protein include:

  • Meats: Chicken, turkey, lean beef, pork, etc.
  • Fish: Mackerel (relatively cheap), salmon, sardines, haddock, trout, etc.
  • Eggs: All types.
  • Dairy: Milk, cheese, yoghurt, etc.
  • Legumes: Kidney beans, chickpeas, lentils

Why not try planning a higher protein meal and pay attention to how you feel afterwards, how long you feel full? Plan it in advance so that you have time to adjust your emotions in order to manage it if it’s really hard.

Note that if you have kidney disease associated with your diabetes, you should speak to your doctor before making any changes to your protein intake.

Eating more healthy fats including olive oil, oily fish such as salmon and mackerel, avocado, seeds and nuts will also help you feel fuller for longer, whilst not impacting your blood sugar levels.

Selection of healthy fat sources on wooden background

   5. Do something else

My first blog covered the importance of maintaining mental wellbeing during times of stress and included some practical steps to reduce stress and relax.

Another option would be to learn a new skill.

An old/aged Indian Bengali man in blue shirt is gardening on a rooftop under the open sky

It’s never too late to learn.

5 years ago, Priscilla Sitienei was sitting at the front of the class at a school in rural Kenya. She had never learned to read or write previously, so she started attending lessons at the local school – along with six of her great great grandchildren. She was 90 at the time.

The older mind is amazingly fertile. Give it a go, whether it’s gardening, learning an instrument, digital photography, expanding your internet skills or knitting.

   6. Sleep

Getting enough sleep helps normalise the levels of cortisol, the stress hormone, which has an impact on your appetite. We’ve pulled together a few resources to help or you can find out more about some of the available apps here.

The importance of self-compassion

“With self-compassion, we give ourselves the same kindness and care we’d give to a good friend.”

My heart rules my head and I trust it - female torso with hands crossed over heart on a rustic stone effect background with copy space on right side

Sometimes, we can eat to deal with the hurt that we feel inside, which may be as a result of things that happened as a child, and we’ll look at this more fully in a future blog. Learning how to be kind to yourself and changing critical self-talk is an important first step. Try out some of these exercises to help change that inner conversation.

Taking Action

If you’ve got an unhealthy relationship with carbs and are thinking about making some changes, having a plan is a great place to start.

You might want to start with some questions:

  • What? What would I like to change? Having a clear target or objective Don’t try and reach the moon in one go, but take some small steps one at a time, otherwise, it can feel totally overwhelming.
  • Why? What are the benefits of making that change to me and the people that I care about? It’s good to have a vision for what the future you looks like.
  • Who? Who am I going to share my plan with or who can collaborate with me to achieve my goal?
  • How? How am I going to do this? What actions do I need to take to make my vision reality?

Try using the Know Diabetes printable SMART goals sheet to get you going.

 

Recommended reading

For those wanting to read more, some recommended books:

Overcoming Binge Eating. Dr Christopher Fairburn https://www.amazon.co.uk/Overcoming-Binge-Eating-Christopher-Fairburn/dp/0898621798

Freedom from Addiction: The Secret Behind Successful Addiction Busting. Joe Griffin and Ivan Tyrrell https://www.amazon.co.uk/s?k=9781899398461

Your Weight Isn't About Food: Discover the 30 Reasons Why You're Feeling F-A-T: It's Not Just 'Food-And-Treadmills'. It's 'Feelings-And-Thoughts. Dr Jen Nash https://www.amazon.co.uk/Weight-About-Treadmills-Feelings-Thoughts/dp/1527203166

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Dr. Tony Willis

Clinical Director for Diabetes, NWL Health and Care Partnership

Tony has been a GP in West London for 20 years and leads the North West London Diabetes Transformation Programme (NWL-DTP).

His passion is to support people make healthy choices, improve their wellbeing and reduce their risk of developing diabetes complications.