Potential Malnutrition In Pregnancy

Researchers have found that women of childbearing age who drink are less likely to take multivitamin supplements, and risk malnutrition in pregnancy.

No big surprise there.  However, it's important to remember that alcohol consumption prevents the body's proper absorption and utilization of nutrients, even if they are present in the diet.  So if pregnancy occurs, the baby gets a double-whammy: exposure to alcohol and a mom who could be suffering from malnutrition.  Not good.

Women Who Drink Before Pregnancy Less Likely to Take Multivitamins

A Reader Writes About Her PAWS Experience

I got this letter a few days ago. It so closely parallels the article on the Sunrise Detox blog about sugar addiction, and has such a clear outline of the lady’s experiences in early sobriety, that I thought it would be good to publish it here, along with my response. Perhaps some of you folks will be able to relate. The letter is edited for readability and to preserve anonymity, and is being published with the permission of the writer.

I had absolutely no acute withdrawal symptoms when I stopping drinking. In fact, quitting was so easy I never lasted more than 3 months before. I used to do these “stop drinking” bouts twice a year for the last 5 years to cleanse but admittedly, looking back it was because I had a problem with alcohol. It's been over 100 days now. I quit on January 1st.

I'm 46 and I have been drinking since 17. I was a heavy drinker who was always sensitive to alcohol. I could handle booze until I was 40, when I started drinking a bottle of wine nightly. For me, who was small, that was way too much. No one thought I was having a problem because I was drinking alone, hiding at home.

I had no withdrawal but I seem to now have classic PAWS. [Post-Acute Withdrawal Syndrome – Ed.] Where I used to have mental acuity and a really fast mind, I'm now super confused and tired. My first month was complete rage. I was so bloody angry, where did it come from? I seemed to be intolerant and have no censure about telling people off. It's almost comical.

In a sense it relieves me, I can finally not be polite. I used to be so polite and sweet and nice but chronically depressed as a drunk. I'm now angry, which in my book is better than depression. (Can you believe it, I was sure booze didn't create depression because when I stopped for a month before, I was not less depressed. But now that I’ve accumulated over 4 months and am no longer depressed, I SEE that it was alcohol. I just so wish I had got that realisation sooner…so many years wasted!)

Thankfully, the rage has subsided. I deal with frequent headaches, but my most annoying PAWS symptom is sugar craving. I was on a NO CARBS diet for 8 weeks and it helped, but it was too austere to be a happy place (I'm all about extremes) so I'm back to a good diet, meditate daily, do yoga, I'm doing wonderfully except for the sugar cravings. When I feel like drinking like mad, I allow myself the sugar rush. I guzzle a spoonful of molasses or maple syrup, and you know what? It helps me greatly. My only question is, will it ever diminish? It's a sugar craving exactly like when I have PMS — the exact same urge to have sugar with immediate brain POW relief. So since I don't abuse sugar at all except a daily dose of dark chocolate (1 square) or a tablespoon of maple syrup, i think it can't harm me that much. Better than alcohol.

I don't mind that PAWS takes time. In a way it makes me grateful, it reminds me that I'm weaned from my poison. I'm just happy it's not 1 year for 1 year of booze because I would be in pain for the next 25 years.

Thank you so much for your kind presence. I find that you are very present to us. In spirit, in listening.


Hi Ruth,

Don't worry about the sugar for now. Next time you go to your doc, request that she order an A1C test to evaluate the way your body is handling glucose. For the time being, stick with the method you've found. You might try smaller amounts of sugar or — perhaps better — some more complex carbs to see how that works. I'm concerned about blood sugar spikes and bottoms, especially in connection with the rage.

Ah, the rage. Hardly surprising that it has surfaced now that the booze is gone. Booze helps us stuff all manner of things, powerful feelings first among them. At some point you'll be ready to take a good look at things in the past that are causing it, perhaps via a 4th and 5th Step, or with a good therapist. For now, don't sweat it, but you will need to explore those issues eventually. (If that caused any kind of reaction besides, “Oh, okay,” it's proof of the premise. Denial ain't just a river in Africa.) If things get too tough, buy an aluminum baseball bat, find some poor undeserving surface, and whale away at it for a bit. Good upper body exercise, too.

How much we drank has less to do with PAWS than how long we drank and how our tolerance for alcohol developed. Along with tolerance came changes in our brain, as our bodies attempted to adapt to the altered levels of neurotransmitters (NT's) caused by the stimulation of the alcohol and/or other drugs. These are permanent changes that involve receptor sites and other minutia. As a small woman, you got the full treatment. Because women produce less of the enzyme that metabolizes alcohol (ethanol dehydrogenase), it stays in your bodies longer, at higher levels than it does in men. Being small merely exaggerated that. More effects for the money is about the only benefit there.

Put simply, PAWS is the symptoms our body experiences during the period when the brain and other bodily systems are returning to an approximation of normal. They include all the things that you mentioned, some others that you didn't, and sometimes depression. Not everyone expresses the same syndrome, but your list fits right in.

PAWS usually lasts for from 8-10 months to two years, depending on a broad range of variables. There is no way to avoid it, but following the suggestions in the article can ameliorate many of the effects, and just knowing that it will gradually get better is a morale booster, too. Expect some swings: good days and worse days, with the good slowly increasing. It's frustrating for us addicts, because we're used to mood changes on demand, but this is better.

Trust me.

Follow the hypoglycemic diet suggested, and stay away from fad and “cleansing” diets. They have no real validity, regardless of how artful the presentation. Remember that those folks are trying to sell things; there's no profit in simple, good nutrition. Recovery is about reality, and there's some for you right there.

Keep on keepin' on!


Sugar Addiction In Recovery

After we get clean and sober, many of us discover that we are still addicted to sugar: in our coffee, in our snacks, in our desserts and elsewhere. Sugar addiction is common, in and out of recovery. Our bodies have a natural attraction to sweet things. We need sugars and other carbohydrates in our diets, and we are pre-programmed to like them because they are good for us (in the right quantities). They are easily burned by the body for energy. In fact, every cell in our bodies are fueled by glucose, a form of sugar.

READ THE LABEL! This one's not bad

This one's not bad

The problem with our modern lifestyle, however, is too much of one good thing and not enough of another. We get far too much of the wrong kind of sugar in our diet, and we don’t exercise enough to burn it up. Our metabolism, however, makes adjustments in order to insure that we have energy when we need it, so unburned sugars are converted to fat, which is sort of our bodies’ gas tank. Our lack of exercise insures that this fuel supply, too, remains mostly untouched, and so we gain weight.

As we put on weight, through too many calories and too little exercise, our bodies fall victim to a variety of health issues connected with excessive weight, including heart and arterial deterioration, pre-diabetes and diabetes, and several other metabolic diseases.

Our taste for sugar and the problems associated with it — along with poor eating habits in general — make maintaining a healthy lifestyle difficult. Food manufacturers and most cooks know that mediocre food can be made more palatable by adding sugars, and they do so in abundance. The great majority of the calories we get from sugars in our diet come from foods that, if questioned, we wouldn’t even identify as sweets! That’s because we become accustomed to sweet flavors, and don’t even notice them unless they are missing. Careful perusal of the labels on packaged foods will amaze!

Those of us addicted to sugar didn’t ask for it, any more than we asked to become addicted to alcoholor other drugs. For many of us, given too many sweets as kids, it became part of our lives when our brains were still developing. So if we have a “problem” with sweets, the first thing is to forgive ourselves and not beat ourselves up. Sugar is highly addictive to some of us, especially recovering alcoholics, and substitute addictions are common. Combined with any previous histories with sweets, it would be fairly amazing if we weren’t having some problems. Remember that you are on your side, you’re not the enemy!

For those with sugar addiction issues, we recommend finding a meeting of Food Addicts Anonymous or Overeaters Anonymous. FAA tends to fit best for sugar addicts, as their approach to controlling intake is more specific than that of OA. Overeaters Anonymous is a great program. Don’t get the idea that we’re saying one is better than the other. It’s just that FAA’s focus fits best when we are considering foods as an addiction.

Second, we try immediately to address substituting something else for the sugar when we have cravings for alcohol, other drugs — or sugar. Peanut butter and whole grain crackers are good, as they have protein and fats that help assuage hunger and that will not cause blood sugar swings that affect appetite.

We need to watch how we eat in general, and avoid getting hungry. We eat small, well-balanced meals and between-meal snacks of whole grain breads, proteins, beans, nuts,

Good Sugar!

Good Sugar!

bananas and so forth. If we balance things properly, we can probably get by eating less than we are now, because we’ll avoid getting really famished, which brings on the urge to binge.

We need to avoid white flour whenever possible. There are great similarities between it and sugar as far as the body is concerned, and it will only prolong and increase cravings. We try to stick with fruits and high-protein snacks, and we check ingredients carefully for their sugar content.

It is most important that we see a doctor for a checkup and lab work. There are metabolic issues that can affect cravings for both sugar and alcohol. If there, they need to be addressed.

Baaaaad Sugar! BAD!

Baaaaad Sugar! BAD!

We also avoid dieting — like the plague. Weight control is about developing new eating habits for a lifetime. Diets are reverse binges. They teach us nothing about proper eating, and do nothing to develop the lifetime habits that are necessary if we are to maintain good nutrition and healthy weight. Because they are regimens of deprivation, it is extremely likely (if not inevitable) that we will return to our old eating habits, gain the weight back, and enter a dieting and eating cycle that can only defeat us and cause us to decide that our efforts are useless.

As with any other addiction, we are likely to fall off the wagon and into the sugar bowl occasionally in the beginning. We are going to be learning how to manage our eating in a whole new way. Relapse is a symptom of addiction, and it’s going to happen in this case because it’s impossible to eat perfectly regardless of how hard we try. If we “slip,” we can be thankful that it isn’t as deadly as drinking or drugging would be, and decide that we will do better. We don’t think of ourselves as weak, or strong. It’s about powerlessness. It’s also about reality. We can’t expect to be perfect. If we make mistakes, we immediately return to our program. We can’t abstain from food, so if we slip, we just decide to do better. We try to be good to ourselves.

Buddhists talk about “skillful” and “unskillful” behavior. In recovery, we want to become more skillful in our ways of living. When we’re learning, we’re apt to make occasional mistakes. That’s human, not weakness. Keep moving toward skillful. Forget perfection — that way lies more addiction.

Vitamins In Recovery — A Personal Opinion

2013-03-19 16.44.57It isn’t uncommon for me to get questions about nutrition, particularly the role of vitamins in recovery. Let me say at the outset that I have no desire to get into a debate about it. There are huge industries with a vested interest in promoting vitamin therapies, and they use extremely effective advertising to attract people to their products. Many of those folks swear by their various courses of nutritional supplements, and that’s okay. I’m not going to buck the current of billions of dollars worth of merchandising, nor am I interested in changing anyone’s mind.

In most respects, however, I disagree with the concept of vitamin therapy.  In fact, I hold a pretty conservative viewpoint on vitamins, in recovery and otherwise. We evolved to get them in certain quantities, and it's difficult for me to imagine how messing with basic body chemistry is beneficial.  Most experts who are not connected with the vitamin industry agree that there is no point in supplementing heavily unless blood tests have indicated an insufficiency of a particular vitamin, such as vitamin D.

Of course, those who do have an ax to grind, either because of ties to the industry or their own endeavors (books, websites, health food stores, etc.) take an entirely different view. The information here is based on good medical advice, and that’s all I have to say about it.  Most nutritionists agree that we require vitamins and minerals only in tiny quantities, and that what isn’t absorbed literally goes down the drain. I once read a nutritionist’s summation: “Americans have the most expensive urine in the world.”

As addicts, we love the idea of some magical pill that will make us “all better,” but it doesn’t exist. The repairs necessary to recover from addiction will take place with abstinence, a good diet, exercise, rest, and — important to a remarkable degree — fun and relaxation. And it takes time; physical recovery from addiction, including alcoholism, can take up to two years. We feel better long before that, thank goodness, but it can take that long for our brains and the rest of our bodies to get back to something like normal.

However, we addicts are used to getting results fast. It’s no accident that the drugs that are most rapidly addictive are the ones that work the fastest. We think in the short term, and we don’t like to wait — for anything. Good nutrition, exercise and so forth take attention and work, and there’s no instant payoff. That’s our biggest hangup in recovery: wanting the magic pill.

That said, all alcoholics (and most other addicts) suffer from malnutrition to one degree or another. Alcohol prevents the small intestine from absorbing nutrients properly, and interferes with the intestinal bacteria that produce many of the nutrients we need. As a general rule, I believe that absent a doctor’s recommendation most of us do fine with a multivitamin every day with a meal (I take mine with breakfast). Because I have also been diagnosed with a vitamin D deficiency, I take supplements of that as well along with certain mineral supplements prescribed by my physician.

In the case of early recovery, no harm — and much good — can come from taking a high-quality multivitamin in the morning and one in the evening — always with a meal. Vitamins are food, not medicine, and must be digested with other food in order to be properly absorbed.

My personal opinion is that after the first year or so in recovery, people who eat properly and get a bit of sunshine and some exercise along with proper medical care probably don’t require more than a multi a day, and perhaps a mineral supplement if the multivitamin doesn’t provide them.  This obviously doesn't apply to folks who have been told to take certain supplements by a physician.

Of course your mileage may vary.  If it works for you, great! Whether it’s vitamins or the placebo effect, the whole point of recovery is to feel better and get on with our lives.

The Extraordinary Science of Addictive Junk Food

“As a culture, we’ve become upset by the tobacco companies advertising to children, but we sit idly by while the food companies do the very same thing. And we could make a claim that the toll taken on the public health by a poor diet rivals that taken by tobacco.”

– Michael Mudd, former Vice President at Kraft Foods

The Extraordinary Science of Addictive Junk Food – NY Times

Blood Sugar and Recovery — A Critical Issue

The farther I got into the mind, body and spirit thing that is recovery, the more I realized how completely the three aspects dovetail. It is possible to be spiritually and mentally healthy while in poor physical condition, but generally the aches, pains and discomfort associated with such things — even with poor nutrition or lack of exercise — will interfere with our overall recovery. As someone so succinctly put it (it may even have been me), “When you feel like hell, it's hard to rise above it.”

In recovery we say, “Don't get Hungry, Angry, Lonely or Tired” (H.A.L.T.). It's amazing how often those seem to go together. We feel low on energy, may have a dull headache, and become irritable, stubborn, and prone to seemingly irrational fits of anger or even rage. I've often wondered how many cases of “Road Rage” could have been avoided if the perpetrator had eaten a decent snack before beginning the drive home after work.

What we're talking about here is levels of blood sugar. Regulation of blood glucose is one of the many bodily functions that are messed up by alcoholism and addiction.  Roughly 25% of the calories we eat go to keeping our brains operating at their most efficient level. When our blood sugar begins to drop, our brains begin to malfunction for lack of fuel, and that can cause big problems.

Until recently it was thought that each person's reaction to a given level of blood sugar was pretty much the same, but it has been found that many people are affected emotionally by glucose levels that were once believed to be within the normal range.

To find out if you suffer from mood swings caused by low blood sugar, use this easy way to self-diagnose. Get a small candy bar and a package of snack crackers (not cookies). About three hours after your last meal or snack, eat the candy bar. Begin keeping track of the way you feel. The symptoms of sub-clinical hypoglycemia may include any or all of the following symptoms:

* Irritability, ranging from mild to raging
* Low energy
* Depression
* Rigid facial muscles (can't smile)
* Muscle tension
* No sense of humor
* Dull headache
* Minor visual disturbances
* A jumpy, edgy feeling
* Difficulty concentrating
* Light-headedness.

These symptoms will normally begin to occur within an hour, often in much less time, and tend to worsen rapidly. Once you have satisfied yourself about the symptoms, go ahead and eat the crackers; they'll help stabilize your glucose and bring you back to normal.

The cure is simple: don't get that hungry. Our bodies are designed to work best when we eat several small meals a day, rather than three larger ones. We have artificially imposed a schedule on them that they don't accept well. We should eat a good breakfast, not too heavy on sweets, because we have been fasting for a third of a day.  A low-sweet snack at mid-morning will hold us until lunch, at which time we again avoid heavy sweets. A mid-afternoon snack will take us through the rush hour commute to dinner time, with a reasonable dessert, in a far better mood. A high protein snack before bedtime will help us sleep better.

The big trick is to avoid things that will cause our blood sugar to rise quickly, like our candy bar on the empty stomach did during the test. When our glucose level rises too rapidly, our bodies overreact and bring it down too far and too fast. That's what causes the hypoglycemic episodes — the blast of sugar. If it was accompanied by caffeine, the result is likely to be exaggerated even more. A low-sugar snack will bring the glucose up slowly and avoid the overcompensation. Obviously another candy bar would bring it up, too, but that will result in chasing our blood sugar curve all over the place, and many of us are doing that already.

A common complaint is “I can't eat all those snacks — I'll gain weight!” You will probably find, if you choose your snacks carefully, that you'll actually eat less over the course of a day because you won't be as hungry at meal times. Also, remember that we're cutting down the sweets. Sweets are OK, but not by themselves. We need to have them after a decent meal, or small amounts with our snacks, to avoid that blood sugar “spike.”

Give up the donuts and coffee for breakfast and the high-sugar snacks between meals. If you can make yourself reduce your caffeine intake, that's good too — especially if you're in the habit of drinking sweetened coffee or energy drinks on an empty stomach. Try it for a week, and keep a log of how you feel. You may be amazed at the difference it will make in the quality of your life. I was.

This is also the recommended diet to reduce the chance of developing diabetes, especially when combined with exercise and sufficient rest.

Remember, the Universe will cheerfully refund your misery at any time; all you have to do is ask.

Willpower, Glucose, and Belief

BrainBlogger has an interesting article detailing recent information about willpower and its relationship to our opinions about ourselves and our nutrition. Well worth a read for those of us in recovery. It's one more reason to keep an eye on our diet and how we think.