- There are so many components to well-rounded holistic health –– why do you focus on cravings and the science behind them?
Cravings are a symptom of something bigger. Food is a common “drug” of choice for people that provides short lived gratification and relief. Nutrition is the foundation of holistic health, and we need to understand why people have a hard time making better decisions about food and sticking to them. It’s not just a matter of eating one food or another; that is just a piece of the puzzle. The science behind cravings is fascinating and reveals the interconnection of multiple body systems. I could have chosen to focus on headaches, for example, instead of food preferences, but because food is such a big and important subject that affects our day-to-day existence, I felt drawn to talk about cravings in order to help others understand their bodies betters.
- What happens to our body when we crave something? What happens to our body when we cut out something we crave? Can you explain why it’s so hard to break a craving?
More often than not when we crave something there is usually an underlying neurotransmitter serotonin-dopamine imbalance that also includes abnormal cortisol levels, which is our fight or flight hormone. This is why when you’re stressed you crave something sweet, because cortisol gets elevated and its job is to raise the blood sugar. Higher carbohydrate foods stimulate the release of serotonin, and dopamine is what solidifies the behavior. Drugs have the same effect—they stimulate the release of serotonin, it makes you feel good, and dopamine gets you hooked. When you cut something out like carbs, cigarettes or alcohol, you no longer have something that fuels those pleasure pathways. It’s hard to break those cravings because serotonin and dopamine are primal pleasure pathways that serve a protective purpose—as far as our mind is concerned, feeling good is preservation, and feeling bad is danger.
- Are some cravings harder to break than others? Is chocolate harder to give up than salty snacks? Does it vary from person to person?
Some cravings are definitely harder to break than others, and it depends on many variables. I talk about chocolate in my book, and although there are many benefits to raw cacao, the sugar that most chocolate bars contain offsets its benefits. If you’ve ever had 100% raw cacao chocolate bar which only contains cacao and cocoa butter, you can only have a few bites rather than the whole bar! Cacao also affects our opioid receptors in the body, while salty foods do not have the same effect. From a physiological perspective, chocolate can be harder to give up, but from an individual perspective that may not be the case. Some people could care less about chocolate, but are all about potato chips. This is one of the reasons I talk about the role of genetics and hormones—sugar sensitivity can in part be due to genetics and a hormone imbalance such as with adrenal or thyroid gland dysfunction (glands that are responsible for our metabolism to say the least) can make people more susceptible to sugar or salt cravings.
- Can you discuss some of the case studies you referenced to inform your book?
It was a great privilege to share some of my clinical cases. In fact, many times I had to write in between patients because I would get inspired after the visits.
One of my favorite case studies was about a woman who was an executive working in tech who had a bad sugar addiction without even knowing it. She was in complete denial until we dug deep. She had a couple chai tea lattes a day, some cookies at the end of the day, and ate processed food because she was going to grad school and that’s all that was available. When she tried to get off sugar, she felt horrible—headaches, irritability, fatigue—and that stopped her from excluding sugar from her diet. We worked on her diet by replacing processed sugar and carbs with whole foods and healthy sweet alternatives, balanced her hormones including her cortisol levels, incorporated meal prepping to help with her grad school schedule and office meetings, and worked on incorporating more movement and exercise into her daily routine to help her balance blood sugar and become more in tune with what she needed.
Another long time client of mine was following one of the more popular 30-day challenges that she also paired with her workouts, and felt so cornered with what she could eat. According to the challenge, you couldn’t make treats even from “approved” ingredients because it was considered a dessert. As an example, my client thought she couldn’t have her morning smoothie, because it would be considered a treat by the challenge guidelines. Not only did my client feel better with her morning smoothie, but it also made her morning routine with three kids so much better. This was an example in my book of the importance of eating foods that are minimally processed, make your body feel good, empower your life, and work for you rather than what someone else says. I have clients who thrive on a vegan diet, and clients who try to be vegan only to find out that they are super sensitive to legumes like lentils and beans. I also have clients who are omnivores and love it, and those who should cut back on their meat intake.
Nutrition is highly individual, but we can all agree that sugar and processed foods have no place in our diet.
- Can you be healthy without eating healthy? Basically, there’s an idea that if you work out and burn calories, that you can eat what you want. Is this a myth?
In my clinic, I look at many dietary logs, basic labs that everyone gets once a year and specialty labs like nutrient testing, hormones, and gut health. Every once in a while, someone who eats the standard American diet will come in for an evaluation just to see how they’re doing, and not only are their labs perfect, but they are also happy, no issues with weight, feel satisfied and fulfilled in their life. That is an anomaly! I see one client like this every couple years. But what I also see is people who eat healthy, exercise and are not only unhappy with how they feel or look, but their lab tests are also abnormal. I think proper nutrition and exercise are key to good health, but in the context of a hormone imbalance they can be fruitless. Take my personal experience as an example, and I share this with my clients and publicly because I think it’s important; I experienced a hormone imbalance—drop in sex hormones, cortisol imbalance (high and low) and hypothyroidism after I had my son. I was eating right and exercising as usual (I was raised as a competitive athlete, so nutrition and physical activity came easily to me), but having a hormone imbalance was offsetting anything I did. I was losing hair, my skin was breaking out, my libido dropped, and I barely had the energy to workout. I had to do what I normally tell my clients—evaluate on what level the problem is and use alternative and conventional treatments as needed to regain optimal function.
- While your work is about cravings and diet, it also addresses mental health and wellbeing. Did you study psychology to understand food’s connection to the brain? Are mental health practitioners beginning to understand this correlation?
My education does include psychology and counseling, and I also have experience in clinical psychology. I work with clients who have a counselor or a therapist on board, and that can be very helpful at times when they can help people make the link between emotions and food. I wish that more mental healthcare providers would see the impact that nutrition can have on mental health. Unfortunately, there are some that I’ve shared workspace with or who I know personally who only focus on behavior and tactics, and not at all on nutrition and lifestyle. That is changing, however.
- Can you recall an experience where you saw someone’s diet directly impact their mental health?
I see this very frequently in both adults and kids. Frequently, parents will bring their kids in for anxiety, depression, and lethargy and when we clean up the diet by taking out processed carbohydrates, sugar, dairy or other foods they are sensitive too, we see a big difference. Similar with adults, but with them there is usually and underlying hormone imbalance that can impact their mood. For example, women tend to be more sensitive, anxious, experience severe cramping or are irritable around their menstrual cycle. That is a sign of a sex hormone, progesterone, deficiency, which is frequently overlooked in conventional medicine. Diet plays an important role, but in the end we still need to support the body with higher interventions in the form of supplements or compounded medication to help with mood, anxiety and balance hormones as well.
- Why did you pursue an ND, as opposed to other medical degrees?
My mom was a conventionally trained family physician when I was growing up. She was one of the first people to expose me to both sides of medicine—the alternative and the conventional. She emphasized nutrition and exercise first, supplements second, and only pharmaceuticals as necessary for a short time. As you can imagine, this is not how conventional doctors commonly practice, so when I went through the interview process for medical schools, I was in for a shock. I actually also saw a naturopathic physician when I was a teenager and had my first B12 shot when I was 16 years old. Between my mom and my naturopath, I thought that’s what medicine was like. The idea of being a naturopathic doctor was much more appealing—I felt that I could not only help people get rid of their diseases, but empower them to be in charge of their health. I didn’t want to be part of a model that for every symptom prescribed a pill, and instead chose a path in medicine that looked at the whole person and the interconnection of all systems.
- Are there efforts to have naturopathic medicine covered by insurance? Do you see this happening in the near future? If not, what recommendations can you make for people who can’t afford to pay out of pocket?
There are many efforts being made to have naturopathic medicine be covered by insurance and to make it more available in different states, as licensure varies from state to state. However, what I am also seeing is that the insurance model is not working—people have high deductibles, and some coverage and providers get pinched by insurance companies. Most people are dissatisfied with the insurance model as it doesn’t treat the person, and providers who work under insurance are mostly concerned about getting to the diagnosis versus the root cause. To get to the root cause sometimes requires a much greater depth of work and interaction with people that insurance simply doesn’t cover, not to mention the treatments that may be needed. I understand the cost issue, but people will usually spend more money using insurance by the time they arrive at a naturopathic physician’s office. There are finance options available, such as through Parasail, for those who are paying out of pocket. Companies are also getting better at giving employees FSA or HSA cards which provides a certain amount of money that employees can spend on health related goods and services.
- As we enter cold and flu season, what advice can you offer for readers to take to stay healthy?
Prevention is key! I have the following supplements on board that I highly recommend and that anyone can order online. Here’s how I recommend people take them:
- Throat spay containing propolis, honey, and apple cider vinegar. Use this at the first sign of a cold! I use the Honey Garden spray.
- Daily Immune for kids and Kick Ass Immune for adults by Wish Garden herbals. This is a blend of herbs that you can take daily that support your immune system.
- Elderberry syrup also by Honey Gardens for both kids and adults. Kids usually just need a teaspoon a day, and adults can do a tablespoon.
- Vitamin C, 1000-2000 mg daily and Vitamin D 2000-4000 IU daily, especially if you live in northern latitudes like Seattle.
- In acute stage, I also like Viracon by Vitanica and reishi mushroom extracts. You can use the reishi mushroom for prevention as well, as it has a lot of research showing the positive impact that it has on the immune system function.
Dr. Elena Zinkov is a leading voice in the field of naturopathic medicine and the author of “Crave Reset: A Breakthrough Guide for Mastering the Psychology and Physiology of Cravings.”