Gene-based nutrition in recovery

If you went to AA (Alcoholics Anonymous) meetings to get sober, you remember the overabundance of coffee and cookies available (not to mention smoke). At OA (Overeaters Anonymous) meetings you find a number of people who are coming from other 12-step meetings, people who originally treated their alcohol or drug addiction and now find that their eating has become compulsive. I hear OA people say that they were aware of having a food problem before having an alcohol problem. Overweight people with binge-eating disorder are more likely to have a family history of substance abuse than the general population. So, what's going on here, and what needs to be done? Is it emotionally-based? Physically-based? If you're in recovery, or have a family history of addiction, are you destined to also have a food disorder? If you do have a food disorder, what should you eat? (The "what should I eat?" question also plagues the general population!) The other day I glanced at a book called Fat is not your fate: outsmart your genes and lose the weight forever, written by Susan Mitchell and Catherine Christie who are registered dieticians. I probably would have passed it by - who needs another book on diet and weight? - except that out of the six food plans offered, one was devoted to addiction-linked weight gain. These authors have looked at genes (our inheritance from our mother and father) and phenotype (those genes which are expressed, or "turned on.") They determined 6 weight gain-causing phenotypes that also correlate with disease-causing conditions: addiction, high blood pressure, cardiovascular problems, diabetes, emotional eating, and hormone imbalance. The genetic grouping that they call Phenotype A includes binge eaters, or people who have gained weight after treatment for alcohol or drug addiction. It also includes former tobacco users. Genetically, Phenotype A people may have low levels of the neurotransmitters dopamine or serotonin, or may have too few receptors for these neurotransmitters in the brain. Therefore the "feel-good" genes in addictive people don't work, leaving them predisposed to find a high in some other way. Studying the biochemistry of alcoholism is not new. Many studies have confirmed the connection between hypoglycemia and alcoholism, as explained in the book 7 Weeks to Sobriety (1992). In The Diet Cure (1999), author Julia Ross gave guidelines for rebalancing body chemistry to end food cravings, weight problems, and mood swings. This new book, I think, builds upon these works and helps implement the information in a practical way that isn't overwhelming. What are the guidelines for the Phenotype A Diet? * Eat 3 meals a day, plus 2 snacks. Each meal and snack contains protein, carbohydrates, and fat in specified amounts. The book lists protein sources (which includes dairy products, soy, legumes, nuts and seeds), carbohydrate sources (certain grain products, high-fiber cereals, fruits, legumes, vegetables, flaxseed, wheat germ), and fat sources (such as avocado, olives, nuts, hummus, and olive oil). This is a regimen of approximately 50% carbohydrate, 20% protein, and 30% fat. If the carb level is too low it will trigger cravings. If the protein intake is cut, you won't get the boost in dopamine levels and a feeling of fullness. Without enough fat, your mood will deteriorate and you'll trigger overeating. * Emphasize certain "focus foods" that are critical to the plan's success: caffeine-containing beverages 4 times daily; protein foods; seafood; walnuts; wheat germ; canola or olive oil; flaxseed meal; and folate foods (green leafy vegetables, fruits, other vegetables, and fortified cereals.) * Take supplements: a multivitamin/mineral, Vitamin C, and Vitamin E. For depression, add St. John's wort or SAMe, and Omega-3 fatty acids. For post alcohol treatment, add milk thistle and B-complex vitamins. * Increase your activity and start exercising regularly. * Keep a food record so you'll have a way to analyze what kinds of food you crave, and determine what prompts bingeing or overeating. A note on caffeine: The Hypoglycemic Health Association of Australia recommends eliminating caffeine because, while it initially raises blood sugar levels and makes you feel good, it is usually followed by a hypoglycemic dip. The phenotype book, however, feels that caffeine is helpful in moderation, up to 600 mg per day. Caffeine boosts the production of dopamine, but not to the same degree as drugs or alcohol. You will need to decide for yourself.