Appetite stimulants

20. December 2007 William Davis (17)
Ever have days when you just can't seem to get enough to eat, your stomach gnawing just a hour after a meal? We all get them, some more than others. Other days, you can be content with a few simple foods and hunger is subdued, temptation easy to control.

Why such contrasts on different days?

A major part of the reason can be the presence of appetite stimulants, factors that trigger appetite beyond rational control. The list of common appetite stimulants includes:

--Sleep deprivation--A very important factor. Lack of sleep drives tremendous appetite, and often for the wrong foods (processed carbohydrates). I personally have experienced my most shamefully indulgent days when sleep-deprived. The solution is obvious: Sleep. Another factor that is based purely on personal observation is that of waking mid-phase. In other words, waking up while you're still enjoying the deeper phases of sleep (e.g., phase 3,4, or REM). This can oddly disrupt your day and your impulse control. I usually try and time sleep to increments of 90 minutes to coincide with the average duration of the full cycle of sleep. For example, 7 1/2 hours is better than 8 hours, since the extra half hour puts your square into a deeper sleep cycle.

--Excessive caffeine--Caffeine stimulates stomach acid. This triggers the impulse to eat . . . and eat and eat.













Image courtesy Wikipedia

--Aspirin and other anti-inflammatory agents--If you take aspirin (as many of our Track Your Plaquers do), then beware of the gastritis that can develop. Like excessive caffeine, it also triggers the impulse to eat, likely a protective mechanism, since food sops up excess acid. I ask patients to take periodic breaks from aspirin, e.g., a week off every two or three months, to allow the stomach to heal. Alternatively, an occasional dose of acid-suppressing medication is a safe practice, e.g., Pepcid AC 10-20 mg; Prilosec 10-20 mg.

--Wheat-containing foods--Followers of The Heart Scan Blog know my feelings on this. Wheat is a potent appetite stimulant: Eat something containing wheat like a pretzel or whole wheat bagel, and you want more. You may want more immediately, or a little later when your blood sugar plunges after the wheat-driven insulin surge. Solution: Dump the wheat, one of the most unhealthy food groups around.

--Alcohol--Though perhaps not a direct appetite-stimulating effect, the loss of impulse-control with alcoholic drinks can lead to overindulgence, often in the worst foods. Just beware.

--Hanging around with heavy people. Remember peer pressure? It can be subliminal. People with poor eating habits provide the silent message that it's okay to yield to impulse, overeat, overindulge, and choose the wrong foods.

--Stress--Whether through cortisol stimulation or other means, stress triggers appetite in some people. If you experience this and must give in, reach for raw nuts or nuts, rather than wheat snacks or chips. The effect will be minimal, perhaps even beneficial, rather than the bloating, appetite-stimulating, fattening effect of crackers, chips, or pretzels. This may be the same phenomenon as taking prescription steroids like prednisone.

--Short dark days, long nights--In other words, winter. Though just an anecdotal observation, I am convinced that vitamin D supplementation is an effective antidote to this effect. The short, dark days just don't bother you as much, perhaps not at all, and there's no impulse for comfort foods.


How about appetite suppressants? In this list I would include 1) raw nuts--especially almonds, walnuts, pecans, and pistachios, the sort with a fibrous covering and rich in monounsaturates, 2) other sources of plentiful healthy oils, e.g, use more olive oil in your salad or add it to hummus for your veggie dip, 3) space-occupying fibers such as glucomannan, inulin (such as in Fiber Choice), and psyllium seed products. Counteracting the above appetite stimulants like sleep deprivation is, of course, important.

The coming wheat frenzy, otherwise known as the holidays, is an especially important time to be aware of these effects. Eat, drink, and be merry--but with rational impulse control not driven by subconscious appetite stimulants.
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Comments (17) -

  • Nancy M.

    12/20/2007 4:16:00 PM |

    You didn't mention one of the biggest appetite stimulants ever.... insulin. They used to inject it directly into anorexics to get them to eat.  That pre-meal release of insulin where you get very, very hungry as you're about to sit down to your dinner.

    Actually, it probably isn't the insulin per se, but what the insulin does, drops your blood sugar.  This is why a low carb diet works so well on moderating appetite, insulin and blood sugar drops are much quieter.

  • Stan

    12/20/2007 6:28:00 PM |

    It is not surprising that you have listed nuts and seeds as appetite supressants.  In my experience the most powerful apetite controller (suppressants if you have eaten enough) are fats!   All fats work like that, especially butter, lard, egg yolks etc.  Typically, our digestive system produces a satiety feedback within 10-20 minutes from eating a meal containing a reasonable amount of fat (for me personally, "reasonable" means 60-80%).  It does not work for low fat high carb meals - then the only restraint is the bulk volume.

    Stan (Heretic)

  • HeartCipher

    12/20/2007 8:15:00 PM |

    Maybe I'm just imagining it but I could swear that I'm less hungry if I drink two large glasses of water as soon as I get up in the morning and then eat 2 or 3 hard boiled eggs for breakfast.

    That keeps me going through lunch as I also snack on almonds during the morning (while doing my 2 month "almond eating personal trial".

    If I manage to have a couple of more eggs for lunch then I'm good until dinner.

    Anyone else had this experience with eggs?

  • Anonymous

    12/20/2007 9:29:00 PM |

    Here's an odd one, but true: diet sodas cause tremendous hunger.  And they especially cause ravenous carb cravings before bedtime on any day a diet soda has been consumed.

  • Dr. Davis

    12/21/2007 2:41:00 AM |

    I have. The combined protein in the white and fat in the yolk are very filling.

  • Dr. Davis

    12/21/2007 2:42:00 AM |

    What an interesting observation!

    This would also be consistent with the recent study suggesting that diet sodas are no different than sugared sodas on long-term impact on weight.

  • chickadeenorth

    12/21/2007 7:09:00 AM |

    Yes I notice eggs can hold me till late aft and ground flaxseed only holds me for 2 or 3 hrs.

  • Anonymous

    12/21/2007 11:02:00 AM |

    It really is remarkable how a heart healthy diet has cut down on my appetite.  Going into it, I never thought this would happen.  I figured I'd have a feeling of starving all the time.  

    A little different question, but a topic that came up over dinner last night, some friends and I have been on a low carb diet for a few months, and have noticed that our hair that was formerly thinning has become thicker.  Have you noticed this yourself, or patients mention this before?

  • Dr. Davis

    12/21/2007 12:21:00 PM |

    Curious. No, I've never seen this effect before. I'll have to watch for it.

  • g

    12/22/2007 3:37:00 PM |

    Yes, I had a pt in his 60s (his 25(OH)D was already 60ng/ml in Nov naturally because he lives in Arizona) and after ONE-WEEK on the TYP meal plan, he reported more hair. a-m-a-z-i-n-g!
    he even smokes still 1/2-ppd.
    I think that TYP somehow magically synergizes things in the body. I wonder why? DR. Davis, you are truly like other talented artists like Emeril... you put things all in a pot *POW*  *BAM* and make them A-L-L.... HAPPY!

    BTW an interesting observation, I've been on Vit D and TYP now for 2mos and I'm getting hit on more than ever... and it aint the Victoria S Superbra *ha ha* ;)
    Keep trackin' and REVERSE-PLAQUIN,
    g

  • MAC

    12/22/2007 10:45:00 PM |

    Re: hair growth and low carb.

    There is a statement in the "Life w/o Bread" book by Christian Allan that too much insulin interferes with human growth hormone levels. Fingernails grow faster and hair growth increases on a low carb diet. This book is about Dr. Lutz who prescribed a low carb diet to his patients for 40+ years in Austria and Germany. The low carb diet puts the body back in balance between anabolic and catabolic processes.

  • Dr. Davis

    12/23/2007 12:39:00 AM |

    Hi, MAC--
    I wasn't aware of that. Thanks.

  • chickadeenorth

    12/23/2007 9:04:00 AM |

    Yes my nails grow like crazy as does my hair and lots on Atkins board said their hair grew and thickened.

  • Anonymous

    12/25/2007 9:57:00 AM |

    Hey g,

    Vitamin D must be an elixer huh?

    Very funny!

  • Anonymous

    1/18/2010 4:33:41 PM |

    Hanging around with heavy people can be bad for your health...?

    Comments like that are very hurtful and feed into the pressures in this country to be the perfect size 2.  Also, it assumes that only fat people eat a lot.  Thanks for that.  Appreciate it.

  • buy jeans

    11/2/2010 7:41:47 PM |

    --Hanging around with heavy people. Remember peer pressure? It can be subliminal. People with poor eating habits provide the silent message that it's okay to yield to impulse, overeat, overindulge, and choose the wrong foods.

  • pammi

    11/9/2010 11:32:04 AM |

    Heart  disease is one of the most  dangerous disease which takes thousands of life every years all over the world. If we know its symptoms and Treatment for heart disease. We can prevent is to large extent.

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Heart disease prevention for the helpless, ignorant, or non-compliant

Heart disease prevention for the helpless, ignorant, or non-compliant

19. January 2009 William Davis (9)
The media outlets are gushing with the "research"/marketing spinoff of the JUPITER trial, an analysis conducted by Dr. Erica Spatz of Yale University, that suggests that statin use should be expanded to many millions more Americans.

USA Today: Study: 11M more should get statins

MedPage: JUPITER Findings Could Boost Statin Use by 20%

Health Day: Millions More Americans Might Be Placed on Statins

WebMD: More May Benefit From Cholesterol Drugs: Study Shows More Would Qualify for Statin Treatment if Levels of C-Reactive Protein Are Considered


You may recall that the JUPITER trial (discussed previously in a Heart Scan Blog post) studied the cardiovascular event risk in people with "normal" LDL cholesterols (calculated, of course, not measured) of 130 mg/dl or less, along with increased c-reactive protein, a crude inflammatory measure, of 2.0 mg/dl or greater. A 54% (relative) reduction in cardiovascular events occured in the group taking Crestor 20 mg per day.

What I see is a confluence of events that have brought us to the "statin drugs are necessary for everybody" mentality:

--The low-fat diet advice of the last 40 years has increased non-fat or low-fat foods that increase LDL, since removing fat from the diet provokes small LDL particle production and increases the inflammatory measure, c-reactive protein (CRP).

--The proliferation of "healthy whole grains" in the diet have also caused an enormous boom in small LDL particles, which is interpreted to the uninformed as "high cholesterol." It has also provoked CRP substantially.

--The advice to reduce salt intake has brought a broad re-emergence of iodine deficiency. When thyroid hormone production flags due to lack of iodine, LDL cholesterol (both large and small) increase.

--Our lives, which are increasingly conducted indoors, have worsened the already substantial vitamin D deficiency. While deficiency of vitamin D primarily reduces HDL cholesterol and increases triglycerides, it can also cause an increase in small LDL and a large increase in CRP.


In other words, a collection of events have converged to provide the appearance of high LDL cholesterol and high CRP. This creates the appearance of a "need" for statin drugs. The JUPITER trial now exploits both the LDL-reducing and CRP-decreasing effects of statins.

I view the foisting of Crestor via the JUPITER argument on the public as taking full advantage of the helpless situation many Americans find themselves in: Reduce fat intake, eat more healthy whole grains and . . . cholesterol and CRP skyrocket! "You need Crestor! See, I told you it was genetic," says the doctor after attending the nice AstraZeneca-sponsored drug dinner.

The notion of using a drug like Crestor to suppress inflammatory patterns is absurd. There are far better, easier, cheaper ways to achieve this goal, along with dramatic reduction in cardiovascular risk. But, to the ignorant, the helpless, or non-compliant with real change in diet and lifestyle, then Crestor does serve a purpose.

I can only hope that the excessive pushing of statin drugs on the public will sooner or later trigger a revolt.
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Comments (9) -

  • Anonymous

    1/20/2009 6:16:00 PM |

    Before going on a low carb diet, my total cholesterol was 245. Doc wanted me to take statins, I said no. So I went on a Low carb diet. After 5 months of keeping the carbs <50 mg daily, my total cholesterol went down to 164. That's all you need to know about this "high cholesterol" scam.

  • renegadediabetic

    1/20/2009 8:24:00 PM |

    After JUPITER, they should be restricting statin presecriptions to those with high inflammation who don't want to give up their inflammatory diet & lifestyle.  When Crestor was tested for lowering cholesterol, they found that is was NOT shown to prevent heart attacks, per the fine print on Crestor ads.  When it preformed better when targeting inflammation, that shoud tell you what the real culprit is.

    The greedy drug companies don't want to lose their cholesterol revenues.  They only want to increase sales.

  • Paul Kelly

    1/20/2009 8:57:00 PM |

    Why am I not surprised at the media coverage of this story?

    A little off topic - but a quick question regarding fish oil gelcaps. I read where fish oil goes from being beneficial to hurtful when it becomes oxidized. Are we better off with gelcaps or liquid? Are the gelcaps protective to prevent the fish oil from becoming rancid?

    Thanks!

    Paul

  • vin

    1/21/2009 9:39:00 AM |

    Crestor is the last statin drug developed and one which is still patented. As far as I know there are no other statins being developed; at least not for lowering LDL levels.  So I guess they will push Crestor as long as they can to recover costs and rake in the profits the company had exepected.

    Once the patent ends then they will stop pushing. Just have to wait.

  • Olga

    1/21/2009 2:57:00 PM |

    Hi Dr. Davis:

    I would like you to fo a post about iodine.  I am a 42 year old mother of two.  To make a long story short, I was misdiagnosed with a thyroid neoplasm which resulted in a hemithyroidectomy following my second pregnancy.  After 5 years of ill health, I figured out on my own that I had a goiter and that high levels of iodine supplementation was required to regain my health.  I was told to eliminate salt from my diet 20 year prior because of a high incidence of heart disease in my family, despite the fact that I have low blood pressure. I am currently seeing a doctor who is helping me stabilize my thyroid function.  The reason I am writing to you is that I also have familial hypercholesterolemia.  Thanks to your program, my HDL and triglycerides are excellent.  Is it possible that the LDL will also come down if I can get my iodine into an optimal range?  Thanks for all the great information.

  • Quelle

    1/21/2009 10:11:00 PM |

    "The proliferation of "healthy whole grains" in the diet have also caused an enormous boom in small LDL particles, which is interpreted to the uninformed as "high cholesterol." It has also provoked CRP substantially"

    Which studies are you talking about in this paragraph?

  • Ricardo Carvalho

    1/21/2009 10:52:00 PM |

    I think this cartoon explains the "logic" behind all this "health" industry - http://www.naturalnews.com/023014.html

  • JPB

    1/22/2009 11:08:00 PM |

    The scary thing here is that there are parts of the medical care industry who are pushing for mandatory testing/drugs/etc. in exchange for lower "health" insurance rates (i.e. "preventative care").  
    I think that we need to preserve free choice for individuals.  I don't know exactly how to ensure this, but I do know that I don't want to be forced into mandatory lipid testing and/or treatment!  Anyone have any ideas on this?

  • Trinkwasser

    1/23/2009 11:49:00 AM |

    Same story here. trigs 380 HDL 25 LDL 165 so I was put on a Healthy High Carb Low Fat Diet, which put my LDL up to 200. The simvastatin reduced this to 75 without greatly affecting the dangerous components.

    Reducing my carbs until my BG no longer spiked (60 - 100g carefully spread through the day) has given me trigs 39 HDL 47 LDL 105

    Now my previous doctor died "unexpectedly" which is a good indication of his competence level, blamed me for not complying with the diet and failed to notice I was actually diabetic.

    My current docs are obviously singing off the same hymn sheet as many of you in the "Blogosphere", their main problem is being forced to follow outmoded protocols. She wasn't fussed by my LDL being over 100 in view of the improvement in the other lipids and though she was a bit wary of my latest experiment of eating more saturated fats which put my HDL up to 55 and brought my LDL down to 93 she can't argue with the result!

    Next experiment will be to drop the statin and see what my unmedicated lipids look like now the insulin resistance has been kicked into touch.

    The big problem here in the UK is accountants, who decree no test strips for Type 2s, TChol instead of Full Lipid Panel and no possibility of a CRP test. Hey they have to cut back somewhere in order to afford all the statins . . .

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