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carb addiction by stefani

Neuropeptide Y: Appetite, Macronutrients, and Yo-Yo Dieting, or, Why Restriction Breeds Carb-Addicts and Disordered Eaters

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Neuropeptide Y is one of several neuromodulators involved in regulating feeding.   These include classic neurotransmitters such as serotonin, GABA, or dopamine, molecules derived from fatty acids like endocannabinoids, and neuropeptides.   (All of which I will discuss at length eventually.)   Every neuromodulator can be classified as orexic or anorexic.  Orexic cells drive feeding.  Anorexic cells do the opposite.  Neuropeptide Y is one of the orexic cells, and it is in fact one of the strongest.

In the photo below (a snapshot I took of a page in an excellent textbook–Appetite and Body Weight by Tim C Kirkham) orexic and anorexic drivers are compared.  On the left are the orexics, on the right, anorexics.  Note how Neuropeptide Y and Leptin are situated at the top of the respective sides, demonstrating their antagonistic behaviors against each other.

 

So NPY is strongly orexic.  When injected into the brains of several species of animals, NPY induces several-fold increases in food intake at any time in the dark-light cycle.  Additionally, it is highly involved in the motivation and search for food.  NPY-injected animals are ravenous and incessant: they will eat even when they have to work really hard for it, even if they have to tolerate electric shocks, and even when the food is altered from the natural product and may in fact contain substances they have aversions to, such as quinine.   In animals lacking NPY, eating is delayed and the animal’s efforts at attaining food are sluggish.

NPY delays satiety throughout a meal.  Thus it augments meal size, time spent eating, and meal duration, irrespective of what food is provided.   Animals certainly have preferences for what to eat, but they will take anything and eat it at length if they cannot get their paws on sweet foods.  This action of NPY, along with other orexins, explains why many disordered eaters need to eat and eat and eat, regardless of how much they like the food.

The most fascinating aspect of NPY, however, in my opinion, is the way in which it interplays with macronutrient cravings.    NPY increases carbohydrate cravings first and foremost: NPY-injected animals show an enormous preference for sweet foods.   But NPY also has a fed-fasted-state feedback mechanism: after weeks of being fed either a high-carbohydrate or a high fat diet–so long as it is high calorie–NPY levels fall (though the animals certainly prefer the high-carbohydrate diet), and the animals stop craving carbohydrates that much.

This all occurs in light of the fact that when one is starving at all, NPY levels rise.  They rise in response to fasting, in response to chronic food restriction, and in response to any sort of starvation signal whatsoever, for example, a drop in leptin levels.   NPY levels also continue to increase as the time spent in the fasting state gets longer and longer.   This means that the NPY-driven craving for sweets increases as the fasted state endures.

Once regular feeding is restored, however, NPY levels fall back to baseline.  In this way,  NPY is meant to moderate energy consumption, with a clear preference for carbohydrates.  Why?  Because glucose is the fastest way to get a “fed” signal firing in the brain, at least on an immediate time-scale.   Glucose spikes insulin levels and therefore leptin, which in turn  signals to the NPY right away that the organism is fed.  However, the “fed” state must endure through longer time scales than one simple meal in which leptin levels spike.   Therefore, a long-term undertaking of feeding with any type of macronutrient ratios should be sufficient to mitigate NPY-related problems, so long as energy intake is sufficient to account for energy expenditure.    In the short-term, however, as mentioned, sometimes glucose is the only way to get the NPY neurons (as well as the hypocretin neurons responsible for wakefulness while hungry) to shut up.

This phenomenon explains in part the failure of so many diets.  Neuropeptide Y is one of the strongest stimulators of appetite, and is it triggered first and foremost by low leptin levels and caloric restriction.  Any detection of a fasted state will lead  to the organism craving carbohydrates moreso than usual, and the cravings won’t really subside unless the organism can convince the NPY neurons that it’s not starving.   Herein lies the rub: people restrict, and drives toward feeding rise.  In particular because of NPY-type drives, that drive is focused on carbohydrates.  The more successful a person is at restriction and at willpower, the harder and harder it gets to maintain that level of restriction.   Eventually the stamina fails, and the organism caves, often to a sweet food.  Recall that NPY delays satiation and prolongs feeding quantity and duration.  What this means is that this one bite of sweet food the person allows himself is all-of-the-sudden one thousand bites of sweet foods.  This willpowering individual feels awful about what he’s done, so he gets back into his routine of chronic restriction.   This is a hell of a cycle to be caught in.  My Pepper readers know this all too well.

Re: what NPY-type activity means for fasting and for ketogenic diets:

Glucose availability in the brain is important for NPY regulation.    Glucoprivation- that is, deliberately blocking glucose activity–has been shown to induce feeding and activate hypothalamic NPY neurons in rats.  What this means is that a brain that runs on limited glucose stores may have increased NPY activity.   Ketogenic organisms run on limited glucose stores.

Since many people who fast and/or undertake ketosis experience decreased appetite, there are clearly other, stronger mechanisms at play in the modulation of their appetite than NPY drives; for example, perhaps the simple strength of leptin sensitivity in signalling to the NPY is powerful enough in these individuals to squelch the drive to carbohydrates.   Or perhaps in some individuals moreso than others gluconeogenesis from the liver is functioning well-enough to get adequate glucose supplies to the brain.  I suspect that both of those ideas are in part true.  Nonetheless, NPY explains in part why some people binge so hard on sugar once they take a step off of the fasting or very-low-carb ladders, even if they are not in explicit restriction like the yo-yo dieters I mentioned above.

Many people talk about the addictive power of carbohydrates.  I agree–it’s horrible.  I’ve talked about it many times, and at great length.  Yet what might be worse in some cases is the physiological basis NPY demonstrates for carbohydrate longing.  And the role that restriction plays in the demonic need for sweet foods.   Being in a energy-restricted state might play one of the more powerful roles in why carbohydrate is so insidious in the contemporary American food psyche.

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Managing director of Paleo for Women and author of Sexy by Nature.

11 Comments

  1. Pingback: Paleo Pepper » Blog Archive » Neuropeptide Y: Appetite, Macronutrients, and Yo-yo Dieting, or, Why Restriction Breeds Carb Addicts and Disordered Eaters

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  5. This is a really interesting post, but I come away from it wondering “what do need to do not to have elevated NPY levels, and therefore, carb cravings? Most of the time I eat pretty strict primal/paleo (I do dairy), and often have some pretty strong carb cravings. If I give in to them, I’m off to the races, just don’t want to stop, like you described. How can I keep NPY levels high enough on a paleo primal eating plan to not have these cravings?

    • My hope in pointing out the activity of NPY is to explain that restriction physiologically begets sugar cravings. I wouldn’t try to focus on fixing NPY in particular– it’s just one part of the whole machine. Instead, I advocate eating as much as we want of whole foods– using sweet potatoes to satisfy the sweet tooth, etc. With love, and with forgiveness, and without any negative self-talk or guilt, I believe we can regain proper hormone balance and appetite signalling.
      If you’re really struggling, I suggest pursuing amino acid therapy. 5HTP has been particularly helpful for cravings, though that should be balanced properly with tyrosine, (they are counterweights of a sort– 5HTP to serotonin and tyrosine to dopamine)… among others. Naturopathic and osteopathic healthcare providers can help with that.

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  7. Stefani,

    Thank you so much for posting this, it is a remarkably well-written explanation of these hormones. I have been trying to eat paleo for the last 18 months and have noticed many of these low-carb effects (particularly when I stay low carb for more than roughly 6 or 7 days).
    Based on this do you recommend controlled carb cycling? I am interested in your opinion on this as well as intermittent fasting, which I know has very mixed results in women, and is something I tend to stay away from.
    Also, I have been taking 5HTP and tryptophan for several weeks to help with my food cravings and high levels of anxiety. I have tried an enormous number of supplements, and this is the first thing that has been significantly effective for me, at least for now.

    I have struggled with anorexia (BP subtype) and have been actively seeking treatment since I was 15. Staying away from processed foods and 5HTP are the only two measures I have found effective. Anyway, I really appreciate your blog and the what you offer in terms of considering paleo in the context of both neurobiology and feminism. (I am a neuro major and a feminist!)

    Keep up the great work, your blog is a treasure.

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  9. Your page is awesome! I’ve been looking a long time to find articles that will explain behaviour, emtions and diets SCIENTIFICALLY. Not just waffle like in magazines. Also really appreciate that your information is directed towards women. I have no question, just want to say keep up the good work!

  10. I’ve read an article in which it was stated that when a person suffer from an eating disorder, the neuropeptide y system is damaged and that this condition is chronic. It’s the reason why it isn’t recommended for recovered anorexics to restart exercising, because it’s a powerful relapse trigger.
    As I’m recovering from Hypothalamic Amenorrhea (I find the information on the website very useful), I’d like to know if you know the links between neuropeptide y and leptine. I understood that leptine is very important to recover a proper hormonal function, but I don’t know how to increase its levels (just eating?).
    Thank you

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