From http://carbsyndrome.com & By : William Wilson, MD | Direct link to source here.
PTSD is a type of anxiety disorder associated with severe stress, often generated by exposure to events such as war, sexual assault, abusive relationships and other types of mental and physical trauma. Certainly these events are stressful and traumatic to anyone that experiences them, but by definition people with PTSD continue to suffer long after the stressful event passes. They may experience flashbacks and nightmares and may suffer unpleasant physical symptoms when exposed to similar situations later in their lives. These symptoms are often disabling and interfere with a person’s ability to function in multiple settings.
Years ago post-traumatic stress disorder was a relatively uncommon condition. The incidence of PTSD appears to be increasing, especially in combatants participating in the wars in Iraq and Afghanistan. This has been attributed to the increased number of tours of duty that soldiers in these wars have experienced compared to previous wars. It is somewhat challenging to determine if rates of PTSD are increasing in the general population, but it appears that they likely are, especially in young people and children. Studies have concluded that the average rate of PTSD in the general population is 7.8% with women experiencing higher rates than men.
Diagnosing Our Way to an Epidemic
I have been practicing medicine for over 30 years and in my experience the incidence of PTSD is clearly increasing in all age groups. The usual argument for this upward trend is that we have become better at diagnosing the condition. I’m not so sure—I have a very good memory and years ago I simply didn’t see so many patients that fit the PTSD pattern of anxiety. Let’s assume that the rate of PTSD is truly increasing. Why would this be so? I have heard many theories over the years, but in my opinion the primary reason is our modern diet. You heard me right—people are now more prone to stress because of the type of food they are eating.
To understand why this is so, I need to walk you back through a little history and basic physiology. The idea that food can affect brain function is not new, but in recent years the idea has been lost in an era of pharmacological and high-tech treatments. UCLA professor Fernando Gomez-Pinilla has spent years studying the effects of food on brain function and in recent years his work has started to make headlines. This past spring Fernando Gomez-Pinilla and Rabul Agrawal published an interesting article in The Journal of Physiology showing that high sugar consumption impairs cognition in rats and that omega-3 fats help to protect the brain.
It appears that it is the fructose portion of sucrose that has this adverse affect on brain function. Sucrose (table sugar) and high fructose corn syrup (HFCS) are made of approximately equal portions of glucose and fructose. Fructose is a simple sugar that is also found in fruit, honey, molasses, maple syrup and agave syrup.
Dr. Richard Johnson has done much of the research showing the adverse metabolic effects of excessive fructose. If a person consumes more than 25 grams of fructose daily—about the amount in three apples, the fructose is converted to triglycerides and uric acid. The liver starts to fill up with fat from the triglycerides leading to insulin resistance, where it takes more insulin to move glucose into cells. Insulin also signals the cells to hold onto fat so it can’t be used for energy. In essence the fat become trapped inside of fat cells. Gary Taubes outlines this process in detail in his excellent book “Why We Get Fat—And What to Do About It”.
High uric acid levels are also problematic. At outlined in Richard Johnson’s new book “The Fat Switch”, high uric acid levels also promote fat storage in virtually all animals, including humans. Elevated uric acid also leads to high blood pressure and endothelial dysfunction, where the lining of blood vessels become irritated, leading to arteriosclerosis, heart attacks and strokes.
Thus sugar and HFCS appear to be chronic toxins akin to cigarette smoking. Dr. Robert Lustig, a pediatric endocrinologist from UCLA, has been leading the charge against the dangers of sugar and HFCS. According to Dr. Lustig, fructose can also lead to leptin resistance. Leptin is a hormone secreted by your fat cells that is supposed to tell your brain that you are full and don’t need to eat any more food. When you have leptin resistance, your brain no longer appropriately responds to these signals.
The Diet-Stress Connection
What does this have to do with stress and PTSD? As it turns out, it plays a very important role in how a person responds to stress. It’s important to remember that humans evolved to deal with tremendous amounts of stress. Those who could not effectively function because of stress likely ended up on Darwin’s short list and didn’t live long enough to pass on their genes. When dealing with stress, it also helps to be in good general health with optimal brain function. In days gone by people with serious medical conditions or brain disorders likely didn’t survive for very long. I don’t think we can say that our ancestors had less stress than we do. They spent much of their time simply trying to survive in a very hostile and stressful environment without the advantages of modern conveniences, public health measures and modern medicine.
In recent years it appears that many common brain disorders including PTSD seem to be increasing in incidence. Over a decade ago Hudson and Pope, two Psychiatrists from Harvard, published several studies suggesting that conditions such as depression, anxiety disorders, PTSD, eating disorders, migraines, ADHD, fibromyalgia and other brain disorders were actually part of the same disease process. They called this condition Affective Spectrum Disorder. Because they never discovered the underlying pathology or triggers of the disorder, their concept never made it out of academic medicine.
Long before I stumbled upon Hudson and Pope’s papers, I also noticed that these disorders seem to run together, often in the same patients. At the time I was measuring the body composition of all my patients and I noticed that people with these brain disorders almost always have excessive body fat, regardless of their size, weight or BMI. Over time I compiled a list of 22 brain dysfunction symptoms that seem to develop in these patients over time. Like Hudson and Pope, I became convinced that this was a single disease process. After years of careful study and observation, I believe that I have indentified the two major environmental triggers of the condition—excessive fructose, mainly from sugar and HFCS and high glycemic carbohydrates, mainly from grains. Excessive amounts of omega 6 fats relative to omega 3 fats clearly makes one more susceptible to the adverse effects of these dietary elements.
A Revolutionary New Disease Model
As Richard Johnson has shown, we now know that excessive fructose is the driving force behind insulin resistance and central obesity. When someone with insulin resistance consumes high glycemic carbohydrates, their brain is bathed in a massive blast of glucose. Although the brain almost exclusively depends of glucose for its energy needs, too much glucose is toxic to nerve cells. Because insulin isn’t required for glucose to enter into nerve cells, high blood levels of glucose mean that the inside of nerve cells are also exposed to high levels of glucose. Over time these magnified glucose spikes can trigger a diffuse brain dysfunction leading to low levels of monoamine neurotransmitter such as dopamine, norepinephrine and serotonin inside the cells. In my opinion low levels of these important chemical messengers cause the 22 brain dysfunction symptoms associated with the condition. There may well be other mechanisms at play, including the direct effects of fructose and uric acid on brain function. Even if we don’t fully understand all the underlying pathology of this condition, it clearly fits the clinical pattern of a chronic disease.
We now call this disease Carbohydrate Associated Reversible Brain syndrome or CARB syndrome. Because the brain plays a key role in auto-regulating fat stores, people with CARB syndrome start to store too much fat even when they lose lean body mass from dieting. They become thin and obese. Obese folks whose brains don’t seem to be working so well—our waiting rooms are full of people that fit this description. The brain controls all the important endocrine glands that deal with stress such as the thyroid and adrenal glands through the hypothalamic pituitary endocrine axis. In people with CARB syndrome this carefully tuned stress-management system is thrown out of balance, leaving them more vulnerable to the effects of stress.
In my experience, patients with a healthy brain handle stress fairly well. They may experience short-term distress when dealing with stressful events, but they get over it and move on. People with CARB syndrome respond differently to stress. They feel stressed when the cat sneezes and when faced with truly intense stress, they often have a difficult time getting over it and their reaction to stress is more intense and prolonged. In other words they get PTSD. Genetic factors, sex and general health also play a role in determining how a person responds to stress.
The Vietnam POW Paradox
A few examples from recent history might help illustrate this point. Studies have shown that the incidence of PTSD in Vietnam prisoners of war was about 4%, markedly lower than the incidence in Vietnam combat soldiers, soldiers in Iraq and Afghanistan and even citizens living today in the United States. These POWs were subject to almost inhuman conditions, often for years. How could they have such a low incidence of PTSD? To date the experts haven’t come up with an answer, but to me it makes perfect sense.
Vietnam POWs survived on insects, rats, tree bark and an occasional treat of rice. They had no access to food loaded with sugar, HFCS or high glycemic carbohydrates. Today we send our soldiers overseas with McDonald’s, Burger King, Pizza Hut, Coke, Pepsi and Red Bull so they can eat the food they are accustomed to eating. As a result, many of them have at least early CARB syndrome. When they are subjected to combat stress they are much more likely to end up with PTSD. They are also more prone to brain damage when they are subjected to blasts from roadside bombs. Depression, anxiety and suicide are also much more common in these modern wars. Patients with CARB syndrome are much more prone to anxiety, mood swings and poor impulse control than people with normal brain function. All of these symptom complexes can be rolled up into the CARB syndrome disease model.
You Behave the Way You Eat
Unfortunately there haven’t been many studies looking at the connection between dietary elements and PTSD. One study published in the Journal of Women’s Health did look at the connection between diet and PTSD symptoms:
This study was based on cross-sectional data gathered from 3181 young females with PTSD. They found that PTSD symptoms were correlated with fast food and soda consumption and to some degree with unhealthy dieting behaviors such as skipping meals, using laxatives, using diet pills, purging and smoking cigarettes to lose weight. Interestingly PTSD symptoms were not correlated with BMI as has been documented in other studies, and the authors speculated this was because many women with PTSD symptoms were using unhealthy measures to keep their weight down. In my opinion what they were really doing was identifying women with CARB syndrome.
Women with CARB syndrome consume more fast food and soda because of their strong carbohydrate cravings, the hallmark symptom of the disease. Even if they aren’t overweight, they always have excessive body fat, qualifying them for a diagnosis of obesity. They are much more likely to fall into unhealthy dieting behaviors, often leading to overt eating disorders. By only focusing on PTSD, the authors failed to see the connection between these dietary elements and the other disorders under the CARB syndrome umbrella. Sometimes taking a broad perspective is more useful than narrowly focusing on one disease.
The Evolution of New Theories
Although formal studies are important to determine if new theories have validity, virtually all new theoretical models come from the world of empirical observation. This process involves making observations in the real world and then coming up with theoretical models that might explain these observations. If you want to learn more about the value of personal experience when it comes to battling health issues, I recommend visiting Jimmy Moore’s web site at:
The CARB syndrome model evolved from observing thousands of patients over decades. Although there is a growing body of controlled studies that support the concept, one of my goals is to attract the attention of the research community so more targeted studies of the CARB syndrome concept can be performed in the future. Because the concept is still evolving and it has yet to be supported by controlled clinical trials, all the treatments that I recommend for managing it involve minimal or no risk.
The Solution—Real Food
If this food-brain connection turns out to be true—and I believe that it is, the best thing we can do to prevent PTSD is to give our soldiers and citizens access to real food. Meat, fish, seafood, vegetables, nuts and some fruit should form the core of any healthy diet. We don’t have a stress elimination pill and we did, I would probably take the whole bottle myself! I’m afraid that stress will always be a part of our lives. The best thing we can do is to prepare ourselves to deal with stress in a way that prevents the long-term consequences of stress. If you are exposed to stress or have already been diagnosed with PTSD, the best thing you can do is clean up your diet. That means eliminating all sugar and HFCS from your diet and restricting fructose intake to less than 25 grams per day. I also recommend that you limit your intake of grains, especially highly refined grains like white flour. I’m not a big fan of milk because of its sugar content, but reasonable amounts of cheese and unsweetened yogurt are acceptable.
As Fernando Gomez-Pinilla and Rabul Agrawal pointed out in their study, omega 3 fats help to protect your brain against the adverse effects of excessive fructose. The modern Western diet is loaded with omega 6 fats from vegetable oils and we no longer consume adequate amounts of the omega 3 fats that your brain needs to grow and make repairs. Although both omega-6 and omega-3 fatty acids are essential for health, the optimal ratio is 1-to-1; that is having an equal intake of omega-6 and omega-3 fatty acids. In modern diets this ratio is often completely out of balance, with a ratio of 15-to-1 or more where people are consuming 15-times as much or more omega-6 fatty acids as omega-3 fatty acids. That’s why it’s important to increase your intake of omega 3 fats by eating more wild fish and grass fed meat and to reduce your intake of omega 6 fats from vegetable oils. Most people need to take omega 3 supplements to get enough of this healthy fat in their diet. Krill oil supplements are an even better option.
Cancel the Cravings
Knowing what constitutes a healthy diet and actually eating one can be challenging when your brain craves food loaded with sugar and starch. That’s why it is also critical to suppress these dangerous carbohydrate cravings. The easiest way to do so is to take the amino acid L-glutamine, at least 1,000 mg three times daily on an empty stomach. This will at least take the edge of your cravings, making it much easier to follow a healthy diet.
Recent research suggests that the ideal diet is a low carbohydrate, moderate protein, high fat diet. Of course this assumes that you are eating healthy fats like olive oil, coconut oil, avocados, omega 3 fats and fats from nuts. Your brain is made mainly of fat, especially DHA from fish and seafood. I guess that gives new meaning to the term “fat head”!
If you feed your brain properly, you will be able to manage the stressful events in your life. Long ago I learned that life is often a series of disasters interspersed with short periods of relative calm. It’s easy to navigate the calm waters, but you need to be ready ahead of time for the disasters. The best way to survive stress without developing PTSD is to take care of your health and avoid getting CARB syndrome, a certain gateway to PTSD.