ON THE COVER:  Julia Ross

ON THE COVER: Julia Ross

The Craving Cure:

The Nutritional Solution to Our Worldwide Dietary Crisis

by Julia Ross

Many of those coming to us for dietary help find it difficult or impossible to follow our suggestions because of their overpowering cravings. In fact, cravings for toxic, ultra-processed, nutrient-void foods have now precipitated a world-wide public health crisis.

• 80 percent of the US population is now overweight, and our obesity rate has reached almost 50 percent. (1) The US obesity growth rate, for decades the world’s fastest and still rising, has recently been exceeded by those of many, mostly third world, nations who have “adopted” our diet.(2)

• Fifty percent of US adults have now been formally diagnosed with some form of Type 2 diabetes.(3) Galloping diabetes rates in many countries throughout the world now equal or exceed our own. In China, the rate is now 70 percent.(4)

• A large international study, published in 2018, found that ultra-processed food intake is linked to increasing cancer rates – to a 12% greater risk of breast cancer, specifically.(5)

Unfortunately, such fearsome realities have had little impact on the world’s eating habits. Our cravings for “highly palatable,” foods outweigh our common sense, our vanity, and even our most powerful survival instincts. The problem is not that we’re mindless, misinformed, or undisciplined. The problem is that our brain is constantly being exposed to the most addictive substances ever known.

The building scientific consensus is that most of us have actually become full-fledged food addicts. This conclusion is supported by almost 40 years of neuroscientific research confirming that the effects of sugars and other ultraprocessed foods on the brain’s pleasure centers are identical to those of drugs like cocaine and heroin. Neuroscientist Nora Volkow, PhD, chief of the National Institute on Drug Abuse (NIDA), has estimated that as much as 60 percent of the US adult population is helplessly dependent on edible narcotics.(6)

These highly compelling, brain-active substances include the following:

• The new high fructose, corn, agave, and fruit syrups;

• Granulated sugar from cane and beet;

• Damaged fats and salt;

• Gluten-containing and gluten-free starches;

• Chocolate, and

• Cannabis.

The biochemical cravings set off by products that combine these substances come in all sizes and strengths. Some cravers complain about visions of chocolate that linger for hours until they finally succumb. Others suffer unstoppable drive-to-the-store-and-eat-it-all-in-the-car now compulsions. The brain’s ancient system of appetite control is no match for the now-constant assault of foods that are carefully designed to disable it.


A Brain-Based Cure for a Brain-Based Dietary Emergency

In the 1980s and 1990s, veteran researcher Kenneth Blum,PhD, a colleague of NIDA’s Dr. Volkow, published several clinical studies demonstrating the positive effects of certain brain-targeted free-form amino acid supplements on the cravings (and negative mood states) that propel addictions of all kinds.(7) These studies prompted me and a number of other US addiction treatment professionals to try adding this nutritional strategy to our existing (and floundering) psycho-spiritual programs. We quickly found them to be stunningly successful and have continued to promote them through an organization called The Alliance for Addiction Solutions (https://www.allianceforaddictionsolutions.org).

As the director of integrative outpatient eating disorder and addiction treatment programs in the San Francisco Bay Area since 1980, I can attest to the remarkable, almost unfailing benefits of brain-targeted amino acid therapy in thousands of cases of food addiction alone.

The Five Brain-Targets of Addictive Substances Like Ice Cream, Cookies, and Soda

My clinic’s work has confirmed Dr. Blum’s premise that five specific brain functions, when repeatedly exposed to addictive substances, begin generating aberrant symptoms including negative moods and overwhelming cravings. The five brain functions:

• The neurotransmitter serotonin, our natural antidepressant;

• The pleasurable endorphins, our natural pain-killing neurotransmitters;

• The neurotransmitter GABA, our natural tranquilizer;

• The neurotransmitter dopamine, our natural caffeine providing stimulation and reward;

• The blood glucose supply that supports all brain activity.

Identifying Which Brain Functions Need Amino Acid Support

Each of these five appetite-regulating brain functions, when disrupted and depleted of their particular amino acid precursors by repeated dietary assault, expresses a unique set of deficiency symptoms. My clinic has compiled these five sets of symptoms into a single assessment questionnaire scored on a 0-10 scale. The scores on this Craving Type Questionnaire (https://www.juliarosscures. com/craving-cure/) identify, at a glance, which brain functions are depleted and indicates which amino acids are needed to restore them.

The five brain functions are each dependent on specific amino acids. This well-established fact of brain biology was the impetus for Dr. Blum’s original clinical studies. Our clinic has found, over the past 30 years, that providing the depleted amino acids as individual free-form supplements quickly and thoroughly silences cravings for drug-like foods. This freedom from craving allows a brain- and bodyrestorative diet to be adopted (and enjoyed!) After three to twelve months, the aminos may be discontinued as long as a diet rich in amino acids and other nutrients is sustained.

My staff nutritionists, together with other health professionals who also provide brain-targeted amino acid therapy, have, over the years, developed increasingly effective protocols. In the process, we have confirmed that the following amino acids can reliably be used to eliminate all five types of addictive craving:

1. Tryptophan or 5-HTP (5-hydroxy-tryptophan) convert to serotonin.

2. DPA (d-phenylalanine) or DLPA (dl-phenylalanine) raise endorphin levels (making them both so helpful in recovery from addiction to opiate drugs as well as to opioid foods).

3. Tyrosine or phenylalanine convert to dopamine and norepinephrine.

4. GABA or theanine raise GABA levels.

5. Glutamine can almost instantly stabilize the brain’s vital glucose levels.

Assessing for Contraindications to Individual Amino Acids

Most of our clients have received immediate benefits from the use of amino acid supplements indicated by their Craving Type Questionnaire scores. But some clients are not good candidates for certain amino acid supplements. Possible contraindications to the amino acids listed above are clearly laid out in The Craving Cure’s “Cracking the Craving Code” section, which is the clinical core of the book.

With sensitive trialing and dosing, most of these potentially contraindicated conditions pose no problems at all. But some, such as melanoma or mania, rule out the use of certain individual aminos (in these cases tyrosine and glutamine respectively). With some conditions, however, no individual amino concentrates at all may be used. Our pregnant and nursing clients, for example, typically benefit safely, instead, from raising dietary levels of amino-rich animal protein and from taking a complete free-form amino blend, like Total Amino Solution.

Note: Those who know themselves to be generally intolerant of nutrient supplements rarely tolerate any aminos well.

Amino Trialing

In 1996, my clinic began adding formal in-office and, more recently, Skype amino trialing to our standard assessment and dosing process. We have since conducted over 20,000 individual amino trials. Positive reactions to a low starting dose (a single capsule of the lowest standard dose available) have typically been observable within minutes and vastly improve treatment compliance. When there is no response, a second dose is trialed.

If any negative effect is experienced during an amino trial, an oral dose of 1,000-2,000 mg of vitamin C powder in 4 ounces of water typically eliminates it in minutes. Note: Trialing Kits can be ordered on cravingcure.com.

Lab Testing for Neurotransmitter Levels

In some cases, we have asked for blood platelet testing, the equivalent of cerebrospinal fluid testing (through Health Diagnostic in New Jersey). We’ve also asked for more widely available, but somewhat less accurate, blood plasma testing, to confirm symptom questionnaire results. We have not found urine testing to be clinically reliable. Its results often contradict clear cut symptoms and the aminos prescribed by lab personnel often have either no effect or harmful effects, in consequence. This has understandably confused and discouraged many eager amino acid therapy practitioners and their patients.

The Amino Acids in Action

I wrote The Craving Cure’s “Cracking the Craving Code” amino acid therapy section with clinicians in mind. It’s broken down into two chapters: 1) general instructions for all five Craving Types and 2) very detailed instructions for treating each Craving Type. Here, I’ll give a case example in which two amino acids were trialed and successfully used. I’ll follow that with some clinical tips on how to use the other amino acids that are needed for eliminating the remaining three Craving Types.

Phil’s Story

Phil was a food craver who had switched from alcoholic drinking to donut and ice cream administration years before, with resulting weight-gain problems and a diagnosis of pre-diabetes. He’d been a martial arts master who’d had many injuries and lots of pain over the years. His Craving Cure Questionnaire scores clearly indicated that his endorphin function was weak. He was on the hyper side, so he found slightly stimulating DLPA, even in a single-capsule trial dose, a bit too “buzzy.” After we neutralized his reaction with 1,000 mg of vitamin-C powder, we trialed him on one capsule of DPA. A few minutes later, he took a deep breath and said, “For the first time in months, the pain isn’t there.” After a week on two DPA capsules, mid-morning and two DPA mid-afternoon and evening, we asked if his need for sweets had diminished. He answered, “I’ve actually almost forgotten about them. I don’t even think about my nightly ice cream sundae ritual anymore!” After three months, he dropped down to one DPA twice a day, successfully. After he’d been able to improve his diet for a solid six months, he found that he no longer needed his DPA supplements, at all.

Re Phil’s Diet: We’ve found that all low-endorphin “comfort cravers” must be especially careful to eat plenty of complete protein i.e. protein containing all 20 total aminos acids, in generous quantity in early “recovery.” At least 4 oz. (or more for males) of cooked turkey, lamb, or equivalent, preferably animal source, protein per meal, particularly at first). That’s because endorphin building requires up to 19 different aminos. In contrast, serotonin and dopamine production each require only one amino acid (tryptophan and tyrosine, respectively).

Identifying Phil’s Endorphin Deficiency

This is an abbreviated list of endorphin deficiency symptoms from my book, The Craving Cure. On the 0-10 symptom severity scale, Phil scored 7-10 on every symptom. This was his primary Craving Type.

• “Love” chocolate or doughy, fried, creamy foods.

• Crave substances or behaviors that give pleasure, comfort, reward, or numbing.

• Are very sensitive to emotional or physical pain.

• Cry or tear up easily.

• Have a history of chronic physical pain or chronic feelings of sadness or loneliness.

Find the complete Craving Type Symptom Questionnaire in The Craving Cure or atcravingcure.com. Our clinic has verified its symptoms through 30 years of clinical experience including over 20,000 individual amino acid trials conducted since 1996.

Those who, like Phil, are low in endorphins are missing out on the enjoyment in life that should be naturally supplied by their internal pleasure-promoters. Though most of our food-craving clients have high scores in more than one deficiency category, their endorphin deficiency scores are typically the highest at all.

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As endogenous opiates, the endorphins can quickly erase discomfort and pain, whether physical or emotional. These inner narcotics come in several forms. One of the three potent endorphin subtypes is called enkephalin. A heavily

The Craving Cure

funded scientific study on the brain-effects of M& M’s, the number one candy consumed in America, found that this chocolate and sugar bomb caused enkephalin activity to increase by 150 percent. The study found this effect on the brain to be comparable to that of the drug opium. 8

When we cannot generate adequate amounts of our own enkephalin or other endorphins, we seek external help to restore our sense of well-being, however briefly, from:

• Chocolate and sugar;

• Wheat’s gliadin content (also known as gluteomorphin) and the milk protein casein (also known as casomorphin);

• Coffee, cannabis, alcohol, and certain behaviors (e.g. over-exercise, porn);

• Fat and salt have milder opioid effects.

Consuming products that combine all of these, and other, endorphin-stimulating substances can generate cravings that literally overpower the brain. This is why, though techniques like mindfulness can modestly raise endorphin levels and reduce “reward-driven” eating temporarily,(9) for most, they are no match for the food industry’s bliss point technology. Fortunately, this lack can be quickly remedied with the help of an unusual amino acid called d-phenylalanine (DPA).

Amino Relief for “Comfort Cravers”

DPA has been particularly well researched thanks to an indefatigable pharmacology professor at Chicago Medical School, Seymour Ehrenpries, PhD. Amino acid supplements come in two forms, an L- and a D-form. Typically, only the L-form can be beneficial, but Dr. Ehrenpries (and other researchers) found that the D-form of phenylalanine slowed down the rate of destruction of endorphin by endorphinase enzymes, dramatically increased endorphin availability, and reduced the need for morphine among post-surgery patients, with no adverse effects.(10)

D-phenylalanine (DPA) is available in two forms:

1) Full strength (500 mg) capsules. People who tend to be anxious, hyper, or agitated, or who need comfort at night, especially love its easing effects. It is also the most potent option when physical pain is a problem.

2) DLPA contains both the D- (250 mg) the L- (250 mg) forms of phenylalanine. Its two-amino content works best for Comfort Cravers who are fatigued, because L-phenylalanine is somewhat energizing (as it converts in part to tyrosine) as well as being an essential component of the endorphin subtype, enkephalin.

Occasionally a combination of both forms works best (for example, DLPA during the day and DPA at night). Whichever amino is used, one to three capsules, taken two to three times a day, is the standard dose.

Note: All of the aminos mentioned in this article are available in IV, as well as oral preparations. The former can help with early alcohol and drug addiction recovery (in addition to oral aminos) but are not needed for food addiction recovery.

Phil’s Secondary Amino Acid Need

Phil’s questionnaire’s second hyper-elevated score indicated significant hypoglycemia and his pre-diabetes diagnosis also indicated that he urgently needed blood sugar- and insulin-regulating help. That help was provided by the amazing amino acid, glutamine,(11,12) which quickly eliminated his frequent blood-sugar crashes and the cravings they incited. It also helped to restore optimal insulin function as this much researched amino has been proven to do. The dose: three capsules, three times a day (AM, mid-morning, mid-afternoon). Glutamine certainly added to his ability to stick with his new high protein, lowglycemic, healthy fat diet, which steadily lowered his HA1C to normal over six-months.

Contraindications: Glutamine should not be taken when mania has been a problem as it converts to glutamate. Interestingly, it can help with bi-polar depression, probably for the same reason. Dosing must be very careful, however, to avoid triggering mania.

Three Other Amino Acids That Can Eliminate Food Cravings (and Negative Moods) 

Now that I’ve illustrated the use of the above two anticraving amino acids, I’ll briefly mention the three others whose clinical usefulness can be so profound. See The Craving Cure for an entire chapter on each of the five anticraving amino acids.

Tips on Using Tryptophan or 5-HTP to Raise Levels of Serotonin, Our Natural Anti-Depressant and Appetite Regulator 

The benefits of these two aminos on mood and sleep are well-know. Their effects on cravings for refined food and other addictive substances are less so. We’ve found that about 80% of those with serotonin deficiency do equally well on tryptophan and 5-HTP. We prefer tryptophan with young children (it’s more nutritious) and with those who are more agitated and/or sleepless (5-HTP can raise the levels of the stimulating stress-response hormone cortisol too high in those whose levels may already be somewhat elevated.) Serotonin levels naturally drop after noon, which is why those with low-serotonin-caused carb cravings and low moods feel worst in the afternoon and evening. Consequently, we typically dose these clients in the midafternoon and evening (with an extra dose, if needed for sleep, at bedtime, or sometimes, in the mid-morning).

Contraindications: 1) Taking any serotonin-targeted meds regularly (e.g. SSRIs, Imitrex) at the same time of day (or at all with more than one such drug). 2) A carcinoid tumor.

Myth Busting: Does 5-HTP or tryptophan always have to be given with tyrosine in a rigid ratio? We have found that these two aminos do not need to be taken at the same time as, and in a specific ratio to, tyrosine. In fact, they should usually be taken separately, and deficiency symptoms should be used to determine individual dosing needs. 5-HTP and tryptophan are mostly needed later in the day, while tyrosine, our natural caffeine, is most needed in the morning (as you’ll see below).

If initial assessment indicates that any one of these aminos is not needed, it should be left out altogether. It can always be added later, if symptoms change. At our clinic, our clients fill out weekly self-scoring deficiency symptom mini-questionnaires, to guide treatment till it is completed.

Tips on Using Stimulating L-Tyrosine (or L-phenylalanine) to Raise Dopamine and Norepinephrine Levels 

Most of our fatigued teen and adult clients prefer to use tyrosine to improve physical and mental energy and focus and to stop their cravings for the caffeinated sodas (including damaging diet and energy drinks) and Starbuck’s lattes; the chocolate; or the pure sugar candy they’ve been using to boost their flagging vitality and concentration.

Children and sensitive or easily agitated adults tend to do better on the milder L-phenylalanine,(13) only part of which is converted into L-tyrosine, the direct dopamine precursor. (Dopamine is then converted in part to norepinephrine and adrenaline.) Note: Tyrosine also provides fail-proof caffeine detox aid!

Dosing: Children and sensitive adults: 250 – 500 mg L-phenylalanine, as needed.

Other teens and adults: 500 mg or more, in 500 mg increments (up to 2,000 mg per dose).

Dosing Time: AM and mid-morning. If needed, they can also be taken in the mid-afternoon if they do not interfere with sleep.

Contraindications: Though, with careful dosing, these two aminos seldom cause actual problems for our clients, there are more possible contraindications to the use of tyrosine and phenylalanine (e.g. headaches or elevated blood pressure) then to any of the other aminos. (See the specific possible contraindications for each amino in The Craving Cure’s Chapter 12.) '

Tips for Using GABA or Thianine to Neutralize Stress Chemistry and Stop “Stress Eating”

Myth busting: Our clinic’s clients’ phenomenal responses to GABA supplementation over the past 30-years contradict a widely circulated, but mistaken, conviction that GABA (both an amino acid and a neurotransmitter) cannot cross the blood brain barrier and can therefore not effectively raise calming GABA levels in the brain. Research confirms that GABA actually can cross the blood-brain-barrier. 14 In practice, we observe that most of our clients get a stronger effect from a little GABA than they get from much higher doses of the other aminos; 125 mg is our starting dose (versus 500 mg of most other aminos), and many clients stick with that dose. Some need to go up to 250 mg; a few need (1-3) 500 mg capsules to get the same results. (We have not liked the effects of 750 mg GABA products.) Dosing: Take GABA two to three times a day, as clients’ particular stress and craving symptoms warrant.

Contraindications: At too high a dose, GABA can lower blood pressure or cause agitation.

How Long Are the Aminos Needed?

Children’s Needs: A few weeks or months.

Teens and adults: Typically, a few months to a year. More than a year if there is genetic neurotransmitter dysregulation (e.g. family history of alcohol or drug addiction).

Julia Ross

Julia Ross

Julia Ross has combined 40 years of experience as a licensed psychotherapist with 30 years of pioneering work in the use of innovative nutritional therapies for the treatment of mood problems, eating disorders, and addictions. The author of the best-selling books, The Mood Cure and The Diet Cure, and now, The Craving Cure, Ross has founded several integrative treatment programs in the San Francisco Bay area and now oversees an entirely virtual clinic for food cravers. She educates health professionals and the lay public internationally and directs training and certification programs through The Neuro-Nutrient Therapy Institute (NNTI). Her work has been featured in publications fromVogue to The Journal of Molecular Psychiatry as well as online and on radio and television. See JuliaRossCures.com.

References

1. Fryar CD, Carroll MD, Ogden CL. Prevalence of Overweight, Obesity, and Extreme Obesity Among Adults: United States, Trends 1960-1962 Through 2009-2010. CDC. September 2012.

2. The GBD 2015 Obesity Collaborators. Health Effects of Overweight and Obesity in 195 Countries over 25 Years. N Engl J Med. 2017; 377:13-27. 3. CDC. Long-term Trends in Diabetes. April 2016. //www.cdc.gov/diabetes/data.

4. Chan M. Obesity and diabetes: the slow-motion disaster. Keynote address at the 47th meeting of the National Academy of Medicine. WHO. October 17, 2016.

5. Fiolet T, et al. Consumption of ultra-processed foods and cancer risk. BMJ. 2018;360:k322.

6. Volkow ND, Baler RD. NOW vs LATER brain circuits: implications for obesity and addiction. Trends in Neuroscience. 2015;38(6):345-52.

7. “ In the 1980s and 1990s, veteran researcher Kenneth Blum, Ph.D., a colleague of NIDA’s Dr. Volkow, published several clinical studies including the following two:” Blum K, et al. Reduction of both drug hunger and withdrawal against advice rate of cocaine abusers in a 30 day inpatient treatment program by the neuronutrient Tropamine. Current Therapeutic Research. 1988; 43(6):1204-1214. Blum K, et al. Clinical evidence for effectiveness of Phencal in maintaining weight loss in an open-label, controlled, 2-year study. Current Therapeutic Research.1997;58(10).

8. DiFeliceantonio AG, et al. Enkephalin Surges in Dorsal Neostriatum as a Signal to Eat. Current Biology.October 23, 2012; 22(20) :1918–1924.

9. Mason AE, et al. Reduced reward-driven eating accounts for the impact of a mindfulness-based diet and exercise intervention on weight loss: Data from the SHINE randomized controlled trial. Appetite. 2016 May 1;100:86-93.

10. Ehrenpreis S. Pharmacology of enkephalins inhibitors: animal and human studies. Acupuncture & Electro-Therapeutics Research. 1985;10 (3): 203-208.

11. Laviano A, et al. Glutamine supplementation favors weight loss in nondieting obese female patients. A pilot study. European Journal of Clinical Nutrition.2014;68(11):1264-1266.

12. Molfino A, et al. Metabolic effects of glutamine on insulin sensitivity. Nutritional Therapy & Metabolism. 2010; 28 (1): 7-11.

13. Alamshah A, et al. l-Phenylalanine Modulates Gut Hormone Release and Glucose Tolerance, and Suppresses Food Intake Through the Calcium-Sensing Receptor. Int J Obes. 2017;41 (11): 1693-1701.

14. Boonstra ER, et al. Neurotransmitters as food supplements: the effects of GABA on brain and behavior. Frontiers in Psychology. 2015;6: 1520.