Psychological and metabolic responses of carbohydrate craving obese patients to carbohydrate, fat and protein-rich meals

Abstract

RATIONALE: A defective central serotonergic neurotransmission has been suggested to result in the concomitant occurrence of an appetite disorder and a disturbed mood. This syndrome was termed carbohydrate carving (CC) obesity. Excessive consumption of carbohydrate-rich snacks would, through a plasma amino acid mediated mechanism, restore serotonergic neurotransmission and thereby relieve the symptoms of atypical depression. OBJECTIVES: To test whether CC obese patients indeed exhibit symptoms of atypical depression, whether these symptoms can be alleviated by carbohydrate-rich snacks and whether they respond differently to the snacks than non-carbohydrate craving (NC) control subjects. Furthermore, we investigated whether differences between CC and NC patients could be related to peripheral metabolic differences. DESIGN: Double blinded, randomized with cross-over. Patients received three types of snacks (100/0/0, 70/29/1 and 35/3/62 energy percent carbohydrate/fat/protein respectively) on three consecutive test days. Before and after snack administration mood and performance were tested and blood samples were obtained. SUBJECTS: 9 CC and 17 NC obese patients, matched for sex, age and body mass index. MEASUREMENTS: Mood states (Pro®le of Mood States and Visual Analogue Scales) and performance (BourdonWiersma cancellation test), serum glucose and insulin and plasma amino acid concentrations. RESULTS: Before snack consumption, CC patients had slightly higher anger and fatigue scores and tended to have lower mood scores than NC patients. The ef®ciency of performance increased in both groups after all snacks. No other psychological effects of the snacks were registered. Psychological and metabolic responses of CC and NC patients to the snacks were similar. CONCLUSION: Although they may have a somewhat disturbed mood, CC obese patients do not improve their mood states through ingestion of a carbohydrate-rich snack. It seems, from a therapeutic point of view, useless to maintain the concept of carbohydrate craving.

Eating disorders, obesity and addiction

“…The so-called carbohydrate craving has often been put forward as a reflection of an addictive process but is without foundation (Benton, 2010). Carbohydrates do not necessarily relieve negative affect or improve mood as is claimed as part of 'carbohydrate craving' (Jansen, van den Hout, & Griez, 1989;Toornvliet et al, 1997;Turner, Foggo, Bennie, Carroll, Dick, & Goodwin, 1991).…”

Ligature-Induced Periodontitis Increased Insulin Resistance and Triglyceride Levels in Wistar Rats

“…In addition, the Wistar strain used in this study has not been reported to have genetic abnormalities in lipid and glucose metabolism. The results of this study suggested that periodontitis induced hyperlipidemia and insulin resistance, independent of known risk factors, including genetic and dietary factors 20) . Several animal studies have reported the role of periodontitis in the pathogenesis of metabolic syndrome.…”

Links between body mass index, total body fat, cholesterol, high‐density lipoprotein, and insulin sensitivity in patients with obesity related to depression, anger, and anxiety

“…Their combination represents a full-blown IRS (Vitaliano et al, 1996), although others do not agree (Philip & Facchini, 1995). On the other side, Toornvliet et al (1997) found a high correlation between ingestion of carbohydrates and lowered anger affects. In addition, cognitive control of the act of eating was augmented during our study (FEV).…”