How to Eat to Change How You Drink, page 9
For these reasons, it is critical to consider this pathway when we begin our discussion about the brain. Many of us think that our brain is the source of our mood or mental health concerns, but the gut may also be at the root of these concerns. Have you ever had a stressful experience that affected your digestion, making you feel sick to your stomach? Have you ever had a “gut feeling” about something? This feeling has been shown to be the result of bidirectional gut-brain communication in which the gut responds to stress and emotion by creating changes in blood flow, digestion, and gut motility.3
In addition to the gut-brain axis, another key area to consider are the critical nutrients that support our mood, mental health, cognition, focus, and overall brain function. This includes not only vitamins and minerals but other compounds found in fats and proteins. And don’t forget, the gut plays an important role in how we utilize the foods we eat. Foods (and vitamin supplements) are only as good as the health of our digestive system, since the gut plays such an important role in breaking down food, digesting, and absorbing the nutrients from the food we eat. Many of these nutrients serve as the building blocks of our neurotransmitters—the brain’s chemical messengers that allow for nervous system function. These functions also include supporting mood, pleasure, reward, sadness, anxiety, depression, and other feelings and emotions.
GETTING TO KNOW OUR BRAIN’S NEUROTRANSMITTERS
Examples of neurotransmitters include serotonin and dopamine, which you’re probably familiar with as two of our brain’s “feel good” chemicals. Let’s dive more into how our body produces our neurotransmitters by getting familiar with some of them:
• Serotonin
• Dopamine
• GABA
• Glutamate
Our brain’s neurotransmitters don’t spontaneously come into existence. They are made through careful biochemical processes that require many nutrients in order to be produced. Amino acids, which are found in proteins, are the building blocks in the production of all of our neurotransmitters. We know that protein in the diet is important because it helps keep us full and builds our muscles, but beyond that, the amino acids contained in protein-rich foods are required for a healthy brain. This is why amino acid therapy has been studied as a potential aid in supporting addictive behaviors and alcohol use; the theory behind this research is based on the idea that by providing the specific amino acids to form neurotransmitters, it is possible to naturally boost the body’s production of these chemicals. These support programs have shown promising results in the production of neurotransmitters that contribute to addictive behaviors.4
We need these nutrients to support healthy brain chemistry, but when we overconsume alcohol, it depletes our nutrient status (see chapter 4). Therefore, we may have an already faulty brain chemistry that is made worse by alcohol use, creating a vicious cycle that is difficult to break. Alcohol itself also affects many of the neurotransmitters, including serotonin, dopamine, GABA, and glutamate. Let’s look more closely at each of these.
Serotonin
Serotonin is one of the most popularly discussed “feel good” neurotransmitters, best known for its association with warding off depression and as the target for antidepressant therapy. However, you may not know that serotonin levels can be low due to nutrient deficiencies. Serotonin is produced in the body using the amino acid tryptophan (derived from protein), and converted through a series of reactions that require B vitamins and minerals to be completed. Serotonin also ultimately converts into melatonin, which as you may know, helps initiate sleep. Turkey is one source of tryptophan, hence the explanation your uncle gives for his post-Thanksgiving meal nap. However, tryptophan is found in many other animal proteins, like chicken, fish, eggs, and dairy, along with some nuts and seeds.
In the graphic below, you’ll see the nutrients required for the production and conversion of serotonin.
Serotonin deficiency has been shown to contribute to impulsive behaviors and alcohol consumption and has long been an area of research regarding alcohol use behaviors.5 This may be because of the link between the serotonin pathway and stress and anxiety levels.6 You may be able to relate to anxiety as a trigger for alcohol use, or to reach for a drink whenever your stress is high. But serotonin is only one of our “feel good” hormones. It works in tandem with dopamine to provide a positive mood and a reduction in symptoms like anxiety and depression.
Dopamine
Dopamine is another example of a “feel good” neurotransmitter heavily involved in the reward and pleasure systems of the brain. In relation to alcohol use, dopamine is a unique neurotransmitter, and its role in drinking behaviors has been frequently studied. Not only is dopamine increased with alcohol use, but according to psychiatrist Anna Lembke, author of Dopamine Nation,7 we can experience an increase in dopamine simply by the mere thought of taking a drink. That means that even thinking about a mimosa at brunch or imagining that glass of wine after work causes a “pre-reward” spike in dopamine, which makes it harder to say no once the opportunity to drink arrives. But after alcohol use has ceased, dopamine decreases—going below the initial baseline level—which can contribute to symptoms of withdrawal or that low mood feeling we feel in the aftermath of a drinking session.8 This intensifies future cravings even further.
Dr. Lembke also points out that alcohol is only one of the many ways to stimulate dopamine production in the brain. It is also stimulated by other drugs and other forms of pleasure—“sex, drugs, and rock ’n’ roll,” if you will. However, alcohol has a much stronger effect on the brain than safer ways to produce dopamine, like being in nature, viewing a sunset, spending time with loved ones, or even eating your favorite chocolate. When we train our brains to use more powerful dopamine producers (like alcohol) on a regular basis, these gentler forms don’t seem as pleasurable. But when we eliminate alcohol and rebalance our brain chemistry, these simple pleasures begin to feel more potent.
Dopamine production also requires nutrients, including the amino acid tyrosine, vitamin B6, vitamin C, and others. In the following graphic, you can take a look at the conversion of dopamine in the brain and the essential nutrients required for its natural production.
When these nutrients are in low supply, the body may not efficiently produce enough dopamine, meaning that we might seek outside forms of dopamine to help us feel pleasure, reward, and other positive emotions.
GABA and Glutamate
One of the ways that alcohol induces feelings of calm is by increasing the activity of one of our relaxing neurotransmitters, GABA, and decreasing the brain’s production of a stimulating neurotransmitter, called glutamate.9 This mechanism is often described with the “gas pedal” analogy. Think of GABA as the “brakes,” helping us slow down and relax, while glutamate is the “gas,” revving us up and energizing us. Based on this analogy, alcohol takes our foot off the gas and presses on the brakes so we can temporarily relax. This is how alcohol acts as a sedative.
These two neurotransmitters are a bit different from the others in that they are both a part of the same pathway. The amino acid glutamine converts to glutamate, which then becomes GABA. In order for the body to convert glutamate to GABA, we need sufficient levels of vitamin B6 as well as magnesium. Unfortunately, between 50 and 70 percent of Americans are deficient in magnesium, which may be associated with the need for substances like alcohol to aid in synthesizing GABA.
Neurotransmitters as an Area of Nutritional Focus
While these neurotransmitter pathways may seem complex, the overall theme is simple: we need to take in sufficient protein, vitamins, and minerals in order to have healthy levels of these important brain chemicals. As we’ve seen, neurotransmitters may contribute to why we crave alcohol or have difficulty cutting back, but moreover, they perpetuate the vicious cycle of stress, anxiety, and depression when we continue to drink.
Genetics can also play a role in neurotransmitter production, which is one of the ways that our genes may make us more susceptible to alcohol or other substance use disorders. One particular gene for the enzyme catechol-O-methyltransferase (COMT), which breaks down dopamine, may be associated with alcohol use, cravings for alcohol, and risk for relapse.10 Many other genes that regulate levels of serotonin, GABA, and other neurotransmitters and their precursors increase the complexity of understanding the true nature of genetics and alcohol use behaviors.
SLEEP AND OTHER BRAIN FUNCTIONS
Because so many people use alcohol as a way to induce sleep, it’s essential to address this critical topic. So much happens when we sleep. We replenish our energy, our brain cleans out cellular waste (a process known as autophagy), and the body repairs dysfunctional pathways. It is a time when all of our systems complete a “reset” for us to function well the next day. Surely you’ve heard this before, but I’ll say it again: it’s recommended you get between 7 and 8 hours of good sleep a night for optimal function.
Alcohol can help induce sleep, but later in the night, it can disrupt sleep. Because alcohol helps boost GABA activity, in this way it can act as a sedative, initially helping us relax and rest. But the metabolism of alcohol is a disruptive process because it creates changes in blood sugar, prompts increased urination due to waste removal, and disrupts REM sleep cycles—all of which play a role in decreased sleep quality, which may be more or less affected based on the quantity of alcohol consumed.
Staying up late (as we sometimes do when consuming alcohol) or simply not getting enough sleep doesn’t just put us at a deficit. It may also cause an imbalance in our normal sleep-wake patterns, which affects cortisol, the stress hormone. And when our stress hormones increase, that makes it more difficult for us to control those urges to drink. This is because of cortisol’s effect on our blood sugar and the desire for alcohol, sweets, and carbs to boost energy when we’re fatigued.
Lack of regular, consistent sleep can cause difficulty with controlling our alcohol behaviors and can contribute to cravings for carbohydrates and sugar, because alcohol and sugar can provide a surge in blood sugar and a hit of dopamine to give us energy during times of sleep deprivation. Reducing our alcohol intake requires a thoughtful approach to ensure we’re getting adequate, restful sleep.
ALCOHOL REDUCES BRAIN VOLUME
While there is some controversy as to alcohol’s possible benefits for the cardiovascular system (as discussed in chapter 1), there’s little argument over the negative effects it has on our brains. A study done by the University of Pennsylvania in 2022 put this debate to rest: the study of over 36,000 middle-aged and older adult subjects found that even one to two alcoholic beverages per day may reduce brain volume, in both the white and gray matter of the brain, as measured by an MRI.11
Simply put, alcohol ages the brain and causes it to shrink. Decreased brain volume affects how our neurons fire—the basis of how our brain sends all of its signals. This has been associated with symptoms that include memory loss, mood disturbances, and other symptoms found in those of advanced age, those with Alzheimer’s disease, or those with a history of brain injury.
KEY FOODS FOR SUPPORTING THE BRAIN
In the next chapter, we’ll take a deep dive into more food recommendations, but for the moment I want to highlight some key brain-supporting foods.
Omega 3s. Omega-3 fatty acids, found in wild-caught fish and some nuts and seeds, have been touted for a vast array of health benefits but get little attention on their importance for the brain. The brain is composed of about two-thirds fat; should we get too little fat in our diet, our brains might suffer. This is not an invitation to consume any and all fats; our brains particularly require omega-3 fatty acids, like EPA and DHA. You may have seen these ingredients listed in supplements to help the brain and even for infants and children to aid in growth and development of a healthy nervous system.
Vitamin D. Vitamin D is an important nutrient with a possible association to alcohol use. Deficiency in this nutrient has been associated with depression, dementia, and other brain-related conditions.12 Vitamin D–rich foods include wild-caught fish, egg yolks, beef liver, and fortified foods (like dairy and soy). The body can also make vitamin D via exposure to the sun; however, there are many reasons why the sun may not be a reliable source for vitamin D needs. Sunscreen, UV blocking windows, and clothing can all affect production of this vitamin through the skin. Those with darker skin tones may have decreased ability to generate the same production as those with lighter skin. In certain parts of the world, the sun is not strong enough to produce this nutrient via the skin. In the northern half of the US, the sun is strong enough only from May to October. Those in the lower half of the US have better odds of skin conversion of vitamin D over the winter. But, if this is your preferred method, 10 to 15 minutes a day of sun on your arms and face is enough to produce sufficient levels of vitamin D, depending on the season and where you live. We’ll talk more about Vitamin D supplementation in chapter 10.
B Vitamins. The B vitamin complex is a category of vitamins that includes B1, B2, B3, B5, B6, B7, B9 (more commonly known as folate, or folic acid), and B12. This entire class of vitamins plays a critical role in brain function and energy production in the body. As we mentioned earlier, certain B vitamins, particularly B2, B6, folate, and B12, are key in the production of our neurotransmitters. B vitamins can be found in a range of fruits, vegetables, beans, and proteins. Vitamin B12 is the only vitamin in this class that can be found naturally only in animal-based foods and thus requires supplementation in those who are vegan or largely plant-based.
Proteins and Our Neurotransmitters. We learned earlier that proteins are made up of amino acid building blocks, which are key to the production of neurotransmitters. For this reason, it is crucial to get enough protein in your diet, especially from complete protein sources containing all of the essential amino acids. Animal sources are recommended for adequate intake. If you eat a vegan or vegetarian diet, be mindful of the level of protein you consume, as plant-based protein sources contain lower amounts of protein and may be missing some crucial amino acids for the brain. Fish, specifically wild-caught salmon, is one of my top recommendations for protein for the brain. Not only does it contain all the key amino acids, but it is also high in omega-3s, vitamin B12, and other key nutrients for the brain. Even if fish is not part of your regular diet today, consider adding it to provide massive benefits for your brain health.
OUR BRAIN AND THE DRINKING ARCHETYPES
When it comes to our specific drinking archetypes, the brain plays a critical role in how and why we choose to drink. Our motivations can be related to dopamine levels, nutrient deficiencies, and even brain neuroplastic patterns. Let’s look at each archetype.
The Social Drinker. As mentioned, the social drinker is often tempted to imbibe due to the rush of dopamine produced in anticipation and sight of the first drink. This can be akin to a Pavlovian response when we’re in a triggering situation13—like seeing a friend we normally drink with or visiting a place where we usually have a cocktail. This learned response is possibly related to our social drinking behaviors. In the social drinker, there may also be imbalances in neurotransmitters, like low dopamine, that may be at the root of the choice to drink.
The Stress Drinker. Neurotransmitters play a big role in how we handle stress and how active our brain can be. As we’ve seen, alcohol stimulates GABA activity and reduces glutamate activity, inducing feelings of relaxation in those with high stress. But this feeling can also be supported by using specific foods and ways of eating that will cause the same neurological effects. We’ll talk about those in the following chapters.
The Habitual Drinker. The habitual drinker will have imbalances in brain neurotransmitters and may not even receive the dopamine “hit” from alcohol like they used to. However, the training of the brain to continue seeking pleasure will cause a continuation of alcohol use, in the hopes of feeling the same sense of pleasure and relief. We drink more and more only to find that same pleasure never comes. This is where many of us hit rock bottom. Mood is low, motivation is reduced, and overall brain function declines. Not only can the habitual drinker benefit from diet and lifestyle changes (like increasing physical activity), but they’ll also benefit from foods that can heal overall brain function to improve memory, focus, cognition, learning, and more.
WHAT TO REMEMBER
The brain is affected by alcohol in both the short and long term. Alcohol changes our brain’s neurotransmitter levels, reduces the size and volume of the brain, and depletes key nutrients that support brain function. Food and specific nutrients are not always readily looked at as a first-line approach when it comes to supporting mood and brain performance, but may actually be the most simple tools to implement to improve how you feel. The good news is that identifying key nutrients that your body may be lacking can help improve mood and brain function beyond the use of medications or other therapies. Simple swaps with food can make a huge difference!
After learning more about the three systems involved in a functional approach to sobriety—looking at the endocrine system, the gut, and the brain—we’re now ready to take action. In the next section, we’ll explore how you can implement these recommendations through food, supplements, and lifestyle to help support the root causes of your alcohol use history so you can make changes that last.
Part 3
HOW TO EAT TO CHANGE HOW YOU DRINK
