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Sugar on the Brain: How to Avoid “Psychobetes” By: Daniel G. Amen, MD and Tana Amen, BSN, RN Have you ever seen a feeding frenzy? It’s where animals like lions or tuna happen onto some available prey and go absolutely berserk. Perhaps you’ve tuned into a nature show on Discovery channel and witnessed this. A female lion takes down an antelope out on the savannah, and suddenly her entire pride is on top of her fighting for the food, growling and snapping to get a bit of the precious meat, scratching and clawing over each other to consume a few precious calories of protein. It’s a stunning sight to witness. Something akin to this happened in the human world in November of 2012 when Hostess, the Texas‐
based snack cake company announced they were going out of business and finally closing their doors for good. Consumers went wild! Across the nation thousands of people fled into their local supermarkets and convenience stores and snapped up every Hostess snack cake they could find. The pictures of emptied shelves looked like the victims of a feeding frenzy—broken boxes and scraps of cookies and cake were all that remained after shoppers gobbled up (at least metaphorically) every Hostess product they could find. While one assumes at least some of these cakes found their way down the gullets of hungry customers, the rash of purchasing lead to an even stranger, particularly human phenomenon. Supply and demand took hold, and suddenly snack items that once sold for a few dollars were selling for a few thousand … or a few hundred thousand. A particularly hot commodity were Twinkies the classic yellow sponge cakes filled with white crème that have long been the object of American urban legend as illustrated by the following ditty known to some of us as children: Twinkie, Twinkie, little cake I do wonder how you bake In the oven all the day Or grown inside a petrie tray The Chicago Tribune reported that a ten‐count box of these little cakes were being listed on Ebay for $200,000 with a buy‐it‐now option of $250,000 shortly after Hostess’ announcement. As this is being written, months later, Amazon is still selling Twinkies for $40 a box (there are only six left in stock so act now!), and you can go to buytwinkies.com and purchase the “Get Crazy Party Pack”—five boxes of 10 Twinkies for a grand total of 50 voluptuous, chemical‐filled sponge cakes—for a mere $499.50. One reporter even told the story of a woman who went to the local Target with her three sons to stock up on Twinkies for their 77‐year‐old diabetic grandmother. Apparently the old woman had expressly 1 asked her daughter to rush out and buy as many boxes of the sugary treats as she could find. It boggles the mind… Among the million ironies in this situation, the most profound is that it’s highly unlikely Twinkies or the rest of the Hostess line will ever go out of production. What’s far more probable, particularly in light of the recent sales explosion, is that another company will buy the recipes and rights to these foods and keep right on manufacturing them. The “Big Food” industry will never give up when dollars this big are at stake. Here at Amen Clinics, we looked on in awe as this phenomenon unfolded, and contemplated what strange times we live in when it comes to food. One day a company is closing down partially because Americans seem to be getting more health conscious and making better decisions about what they eat. The next day, these same folks turn around and go mad buying up every gruesome snack cake filled with sugar and unpronounceable preservatives they can find. On the surface, behavior like this seems almost surreal. That is, until you start to think about the brain chemistry involved. You see, all of these people had one striking thing in common. They had sugar on their brain. Sugar, Brain Chemistry, and Addiction The reason these people were acting like a bunch of crazed addicts looking for their last Twinkie fix is pretty simple: They are addicted sugar. Many Americans are. Our eating behavior is governed by some of the most primitive parts of our brains—neurochemical reward systems that drive us to seek out specific foods that, in Paleolithic times, helped us survive. Amongst the most important of these was sugar. Despite the tremendous change in our civilization, social climate, and food culture, our genes have changed relatively little over the last 10,000 years. And that genome drives us to seek out foods that would have helped keep our ancient ancestors alive. Sugar and fat are at the very top of that list for fairly obvious reasons: They are high in calories, and traditionally they were found in foods that were packed with essential nutrients—foods like, fruits, vegetables, and animal products. This may be why these foods have such a powerful influence on two key chemicals in the brain that drive much of our mood and behavior: serotonin and dopamine. It’s sensible to assume that humans would have developed an internal reward system that would encourage us to keep seeking out foods that supported our survival. It appears this is exactly what happened. Serotonin, Dopamine, and the Reward of Eating Sugar Research out of MIT shows that simple carbohydrates (foods like the sugar in fruit, table sugar, bread, pasta, rice, and others) trigger a release of serotonin in your brain. This happens because these foods cause a spike in insulin (an important biochemical event in its own right that we will discuss later in this report). When insulin goes up, most large chain amino acids, with the exception of tryptophan, are 2 driven out of your blood stream. Serotonin is built from tryptophan. When the amino acid is made more available in your body you synthesize serotonin more effectively. What happens then is interesting. As you may know, serotonin is the “feel good neurotransmitter.” Its job is to boost your mood and make you feel happy and relaxed. That sugar rush you experience after eating a Twinkie is partially due to the effect of serotonin. You eat some sugar, you feel great. You’re happy and energized. When the effect wears off you instinctively go looking for some more sugar to boost your mood again. Thus the cycle of addiction begins. This process is further enhanced by the influence of another important neurochemical called dopamine. Dopamine is the reward neurotransmitter. While serotonin makes you feel happy and relaxed, dopamine makes you feel energized and excited. When you win $500 on your weekly scratcher, the excitement you feel comes from dopamine. (Incidentally, it’s this experience of reward that drives you to buy another Lotto ticket). When you snort cocaine, it’s dopamine that makes you feel high. This fact may seem crude to point out here, but it’s prescient. Here’s why. Recent research has shown that eating something sweet can actually be more rewarding than cocaine. In a study published in the journal PLoS One researchers took two groups of rats and let them choose between water sweetened with saccharine and intravenous cocaine. The results were stunning.i A whopping 94 percent of the animals chose the sweetened water over cocaine. As if this weren’t enough to blow the researchers away, they decided to repeat the experiment using sucrose—regular old table sugar. The results were exactly the same. In fact, the rats continued to choose sweet flavors over cocaine even after they had been injected with the drug and the amounts were escalated in patterns classically seen in addicts. No matter how much cocaine they gave the rats, the vast majority of them continued to choose sugar. Here is what the researchers concluded: “Our findings clearly demonstrate that intense sweetness can surpass cocaine reward, even in drug‐
sensitized and ‐addicted individuals. We speculate that the addictive potential of intense sweetness results from an inborn hypersensitivity to sweet tastants. In most mammals, including rats and humans, sweet receptors evolved in ancestral environments poor in sugars and are thus not adapted to high concentrations of sweet tastants. The supranormal stimulation of these receptors by sugar‐rich diets, such as those now widely available in modern societies, would generate a supranormal reward signal in the brain, with the potential to override self‐control mechanisms and thus to lead to addiction.” Put another way, your ancient brain chemicals are driving you, practically beyond your will to seek out sweet flavors and do whatever it takes to get them into your body. It turns out the Hostess feeding frenzy we saw in late 2012 actually isn’t so different than a pack of lionesses feasting on a carcass after all. Why Acting on Genetic Impulses Can Be a Problem You might ask, “Why is this a problem? If our genes predispose us to eat as much sugar as we can, why not honor that ancient mandate and go after every Twinkie we lay our hands on?” The answer is that we have access to way too much sugar in today’s world—far more than our bodies can properly metabolize. Our ancient ancestors ate only about 22 teaspoons of sugar a year.ii That’s 3 about 110 grams, which is the equivalent to one large apple—per year! Today, American’s eat between 150‐180 pounds of sugar per person per year or about half a pound (454 grams) a day.iii You probably eat four times as much sugar in a single day than your Paleolithic great‐great‐great‐great‐great (add a few more “greats” in there) had in a whole year. Needless to say, the sources of the sugar we eat today are also completely different than they were when we were growing up as a species in the jungle. We aren’t eating four apples a day and avoiding other simple sugars. If we were, our chronic brain health epidemic wouldn’t be what it is today. No, we are eating sugars that are much more destructive. A la the Hostess episode highlighted above, we are eating super‐sweet foods, with tons of sugar (not to mention all of the other chemicals and preservatives added) that are engineered by food scientists to be super palatable—practically irresistible—to the human brain. These foods are everywhere. You can’t walk into a supermarket or convenience store without going past a display of candy bars, cookies, and other sweet treats. And every time you do, your ancient brain chemistry is whispering in the background like something out of Alice in Wonderland, “Eat me”. And too often, you do. Our bodies and brains simply aren’t equipped to handle this sugar load. They break down under the strain. The result is what we see all around us. One‐third of Americans are sick, and obesity now competes with smoking as the leading cause of death in the nation. Excess sugar consumption has been linked to practically every major chronic illness including obesity, type 2 diabetes, heart disease, and, possibly, cancer. We’re drowning under this flood of sugar. The impact of sugar on your brain is no less severe, though fewer are aware it’s a problem. New research is making it clear that our national sweet tooth doesn’t only cause dental problems, it leads to “brain decay”—a condition I refer to as “psychobetes.” Sugar on your brain affects your mood, your memory, your cognitive performance, and more. While there are many mechanisms by which sugar impacts neurological function, three stand out: 1. The impact of sugar on Brain‐Derived Neurotrophic Factor (BDNF), one of the chief chemicals that builds new and supports existing brain cells. 2. The relationship between sugar, insulin, and brain function. 3. Inflammation resulting from overconsumption of sugar. This diabetes of the brain, or “psychobetes,” is a product of this constellation of biochemical events and the neurological and psychological symptoms that lead to brain decay. Your brain is no less affected than your body by the amount of sugar you consume. In fact, the links between sugar consumption, metabolic syndrome, diabetes, mood disorders, dementia, and Alzheimer’s are becoming increasingly clear. Some scientists are now calling Alzheimer’s type 3 diabetes. New research shows us that your brain actually produces insulin as a means to keep brain glucose levels steady, and we now know that reduction in BDNF can lead to a vast array of psychological and neurological conditions including brain fog and memory loss. In the remainder of this report I’ll tackle each of these topics one by one and show you how psychobetes develops. Once we’ve reviewed how the condition is created, I’ll tell you what you can do about. The good news is that you can break your addiction and get sugar off your brain. I’ll explain how. But first, 4 let’s look at how the nasty substance gums up the works and makes your brain about as slow as molasses. BDNF: What Happens When You Stop Fertilizing Your Brain When you were in grade school, you may have been taught that you are born with as many neurons as you’ll ever have. I can hear my own schoolmarm saying, “Brain cells are the only cells in your body that don’t reproduce. You’re born with as many as you’ll ever have. Every time you sneeze, you lose brain cells. So make sure you protect your brain!” While I wholeheartedly agree with that final epithet about brain protection, the rest of what my grade school teacher had to say about brain cells is simply false, though scientists believed it for decades. We now know that you produce new brain cells all the time. This happens especially in the hippocampus and frontal cortex—areas of the brain where learning, memory, and higher learning occur. These all happen to the areas where BDNF is most present. You can think of BDNF as fertilizer for your brain. It’s a protein that stimulates the growth of new neurons and helps support existing brain cells. It plays a critical role in neural development, and it has been shown that a reduction in BDNF is associated with poor cognitive performance, depression, OCD, memory loss, dementia, and even Alzheimer’s disease. In fact, it’s in the context of sugar consumption, diabetes, and dementia, where the BDNF story becomes most fascinating. The Hidden Smoking Gun in Alzheimer’s It has long been known that there is a correlation between diabetes and Alzheimer’s disease. People who have type 2 diabetes are twice as likely to develop Alzheimer’s and other types of dementia than people who do not have blood sugar control problems.iv The question is why? While not all of the mechanisms are clear, growing research is suggesting that a decline in BDNF due to high sugar consumption could be the hidden connection. We now know that diets high in sugar reduce BDNF.v In fact, the connection between BDNF and blood sugar goes further. Reduced BDNF leads to increased insulin resistance (a topic we will discuss more in a moment). This can lead to a very negative downward spiral for your brain—more sugar, less BDNF; less BDNF more insulin resistance; more insulin resistance higher blood sugar which leads to even lower BDNF. It only stands to reason that when you produce less BDNF—the primary chemical responsible for brain cell growth—you may face memory decline and other cognitive performance issues. Take these connections to their logical conclusion, and the more Twinkies you eat, the more likely you are to develop both type 2 diabetes and Alzheimer’s in the future. And keep in mind that it’s not just people with full‐blown diabetes who suffer an increased risk of cognitive decline and Alzheimer’s. A study recently published in the journal Neurology shows that the more blood sugar control problems you have, the more your brain suffers.vi In the study, researchers collected information from 7,027 older women. The women were divided into three groups—those with diabetes, those with pre‐diabetes, and those with normal blood sugar control. 5 The relationship between cognitive decline and blood sugar control was clear. Over the course of the four‐year study, 5.9 percent of women with normal blood sugar showed a decline in mental function as compared with 10.1 percent of those with pre‐diabetes, and 12.1 percent of the women with full‐blown diabetes. The continuum between worsening blood sugar control and increased cognitive impairment was clear. Sugar robs you of your memory and cognitive function. There can be no question. Remember that the next time you order a soda at your favorite restaurant. But the problems don’t end with a reduction in BDNF. In fact, that’s only the first part of psychobetes. Can Your Brain Be Insulin Resistant? Before we answer the question of whether or not your brain can be insulin resistant, let’s discuss what insulin resistance is in the first place as it’s a key player in chronic illness, weight gain, and brain dysfunction of all kinds. Insulin is the hormone that ushers sugar into your cells where it can be burned as energy. Whenever you eat, insulin release is stimulated. The more sugar you eat, the more insulin is released. So if you have some chicken breast and broccoli for dinner, a little insulin is released because there is very little sugar in the meal. If you have bread, pasta, and a soda a massive amount of insulin is released because your body processes all of these foods as sugar. When your body’s functioning normally and you have good blood sugar control, the release of insulin is like a gentle wave on a placid lake. You eat a little sugar, a bit of insulin is released, that insulin ushers the sugar into your cells, it’s burned for energy, and all is well in the world. However, as you eat more and more sugar, that gentle wave turns into a tsunami—insulin pours into your blood stream in massive quantities, more than your body can actually use. You end up with excess insulin floating around in your body. Then another sugary meal and another tsunami, and pretty soon you have so much insulin in your system that your cells become resistant to it (like a drug addict) and your pancreas (the manufacturing station for insulin) simply stops producing it. Now you have insulin resistance. When you become too resistant to insulin your blood sugar stays up all the time, and you eventually develop metabolic syndrome and type 2 diabetes. Understand that, though the diagnoses are different, these conditions are a continuum of the same problem—too much sugar in your blood. It was once thought that insulin was a harmless hormone, even if you had a lot of it in your body at one time. Doctors used to believe that the only job insulin had was ushering sugar into cells—if that was it’s only job, too much wouldn’t really matter. But insulin does much more than this. It’s a major signaling hormone that sets off a cascade of biochemical responses in the body. When you have too much insulin in your blood stream, the results are devastating. It causes your body to store fat, it drives up LDL and drives down HDL, and it may stimulate the growth of cancer cells. If you’re insulin resistant, you need to take action right away. It increases your chances of death well before you become a full blown diabetic. A New Discovery Turns Insulin Resistance on its Head Now, how does all of this affect your brain? 6 Well, scientists have recently discovered that your brain produces insulin. This is an extraordinary finding as it was previously believed that only the pancreas produced insulin. Another significant finding: insulin production in the brain plummets in people who have Alzheimer’s. This has some researchers wondering if the progression of the disease may be associated with the levels of insulin produced in the brain. This is one amongst many reasons some scientists are now calling Alzheimer’s type 3 diabetes. Consider what this may mean … You eat tons of sugar. This sugar is converted (in part) into glucose in your body. Your brain LOVES glucose, glucose is its favorite fuel—it can consume about 125 to 150 grams of pure glucose a day. So it gobbles up all this sugar you are pouring into it. Your brain releases a certain amount of its own insulin which helps get that sugar into your neurons. But when your brain gets swamped with sugar guess what happens? You develop insulin resistance of the brain. Just like your pancreas, your brain stops producing the hormone because it thinks you have enough and your cells can’t use anymore. But here’s where the story gets interesting. Insulin, and a chemical that rides along with it called insulin‐
like growth factor (IGF), are key chemicals that your brain needs to learn, develop new memories, and continue to grow. Brain cells actually have special receptors on them for insulin. Insulin is believed to be one of the hormones that trigger connections between neurons and helps you develop neural networks—it is these connections between neurons that are at the heart of learning and memory. When the connections break down, your memory starts to fail. This is compounded by the fact that when IGF is reduced in the brain, it triggers brain cell death, particularly in the hippocampus and hypothalamus—areas of the brain responsible for memory. Interestingly, a 2009 study showed that giving intranasal insulin to people with mild cognitive impairment or early Alzheimer’s helped memory and attention—further proof that the chemical is intimately related to brain function.vii Unstable blood sugar control damages your brain in other ways as well. It damages blood vessels in the brain, wide swings in blood sugar may destroy existing brain cells, and nerve cell damage throughout the body is thought to be caused by the accumulation of specific end products that end up in your brain. Lest you think that only your memory is at stake (as though dementia isn’t bad enough!) insulin resistance has been linked to a wide array of behavioral and mood disorders including depression, panic attacks, anxiety, insomnia, and ADHD. In fact, a new study shows children who are given sugar everyday have a significantly higher risk for violence later in life!viii Your Brain on Fire The final biochemical mechanism which drives psychobetes that I want to review in this report is inflammation. Systemic inflammation is now widely accepted in nearly every branch of medicine as a leading cause in virtually all chronic illness from heart disease to gastrointestinal dysfunction to chronic 7 pain, and more. It also effects brain function and has been associated with everything from Alzheimer’s to depression. To see how inflammation, sugar, and brain health are linked we must start with a short primer on your immune system and your inflammatory response. When Your Immune System Runs Amuck Inflammation is a lot like your insulin response. When it’s well balanced, it’s critical for good health. When it swings out of balance, it sets of a series of events that can destroy your body and brain. If you’ve ever sprained an ankle, gotten a splinter, stubbed your toe, or basically lived life, you know what inflammation is. It’s the swelling and heat that occur when your body is injured. How and why does this happen? When a foreign invader enters your body—think splinter or virus—your immune system (which is sort of like your own personal homeland security) sends signals throughout your body that say, “Watch out, we’ve been invaded—time to fight back!” Powerful chemical forces are mobilized to deal with the invader, and when it’s functioning properly your immune system handles these foreign bodies with great elegance. Consider the last cold you had. Hopefully it didn’t take more than a couple of days for you to get well. That’s because your immune system—your inflammatory response—was working to your benefit. A slightly different, but very similar set of responses occur when you get injured. So the inflammatory response when it’s working properly burns up your enemies—great, that’s what it’s supposed to do. Unfortunately, sometimes your immune system gets confused (as in allergies and autoimmune disorders), and sometimes the assaults on your body are so regular and so powerful that homeland security thinks it supposed to be in high alert all the time (systemic inflammation). In both cases, your immune system can overreact. In attempt to save the homeland, it starts burning it up. This is when chronic illness develops. Why would the body do this? How could it get confused? There are lots of ways this can happen, but one key influencer is a rapid rise in blood sugar. A major study out of Harvard Medical School has shown that eating large amounts of high‐glycemic carbohydrates turns the inflammatory response way up. Researchers measured c‐reactive‐protein (CRP—a biomarker for systemic inflammation), and found that those who ate the most sugar had the highest and most dangerous levels of CRP. ix More sugar equaled more inflammation, pure and simple. And what does more inflammation mean? For one thing it means your risk of chronic illness skyrockets. It also means that your brain may break down. In fact, it may actually lead to depression. When Your Brain is on Fire You Get Depressed A new hypothesis regarding the origins of depression is emerging. Some researchers are beginning to believe that major depressive disorder may be, at least in part, an inflammatory condition.x The links are numerous: 8 
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People who are depressed tend to have altered immune activity. Increased levels of proinflammatory cytokines (the messenger molecules of the inflammatory system) are found in depressed patients. These cytokines may influence the creation and reduction of neurotransmitters like serotonin, hormonal function in the brain, and regional brain activity in ways that are similar to depression. Patients who receive cytokine treatment tend to become depressed. Are these links alone enough to say that depression is an inflammatory disease? No. More research needs to be done. However, the evidence is becoming stronger all the time. We see a similar trend in the scientific data that links Alzheimer’s, Parkinson’s, and other neurological disorders to inflammation. It’s enough to make me urge caution and encourage people to live an anti‐inflammatory lifestyle in order to protect their brain and mood. And that starts with ending the Twinkie feeding frenzy. Protect Your Brain: Just Say No to Hostess (and Other Forms of Sugar) By now I hope I’ve convinced you that diabetes of the brain—what I call psychobetes—is a very real and very destructive phenomenon. Simply put, having sugar on your brain all the time destroys it. The connections between sugar consumption, cognitive decline, and memory loss are now too clear to dispute. The growing research that links sugar to mood disorders is enough to make me very concerned. If you want to protect your brain, you need to get off the sugar. Here’s how. Step 1: Go Cold Turkey I don’t agree with the people who say “everything in moderation” … cocaine or arsenic in moderation is not a good idea. Neither is sugar in moderation. The less sugar in your life the better it will be … period. I recommend going cold turkey from all sugar or foods that convert to sugar rapidly in your bloodstream. An easy way to identify these goods is to get to know the glycemic index (GI). The glycemic index rates carbohydrates according to their effects on blood sugar. It is ranked on a scale from one to 100+. Glucose is 100. Lower‐glycemic foods are further down on the scale. You want to shoot to stay under 60 with all of your food choices. Eating a diet that is filled with low‐glycemic foods will lower your blood glucose levels, decrease cravings, protect your memory and learning capacity, improve your mood, and it incidentally helps with weight loss. The important concept to remember is that high blood sugar levels are bad for your blood vessels, your brain cells, your waistline, and every other part of your body. Get them out of your diet. And if you’re worried about cravings, don’t be. If you go truly cold turkey, they will vanish for most of you in about three days. Step 2: Focus on Fruits and Veggies In general, vegetables, fruits, legumes, and nuts are the best low‐GI options. These foods are rich in the vitamins and minerals that feed your brain and body. A diet rich in whole, minimally processed 9 low‐GI foods not only helps you lose weight, it has also been found to help control diabetes, according to a 2011 review of the scientific literature in the British Journal of Nutrition.xi That means it will protect your brain from psychobetes as well. Be aware, however, that some foods that sound healthy actually have a high GI. For example, some fruits like watermelon and pineapple have a high ranking. It is wise to consume more fruits on the low end of the spectrum. Similarly, some starches like potatoes and some high‐fiber products like whole wheat bread are on the high end of the list. Eating smaller portions of these foods, thinking of them more like a condiment, and combining them with lean proteins and healthy fats can reduce their impact on blood sugar levels. Step 3: Protein for Brain Power Until the recent “Paleo” movement, protein has been a misunderstood and maligned macronutrient. High‐quality protein filled with healthy fats is actually critical for health. Protein feeds your need for amino acids which are the building blocks of your DNA and neurotransmitters. Without protein, our brains and bodies whither. Does that mean you should eat good ‘ole American corn‐fed beef at every meal? No. Where you source your protein is critical. If you eat red meat, stick to grass fed sources—these are much higher in anti‐
inflammatory omega‐3 and ‐6 fats. They are also one of the few modern dietary sources of CLA—
conjugated linolenic acid—an extremely healthy and anti‐inflammatory trans fat that has also been shown to help with weight loss. I also recommend plenty of fish. Stick to wild, line caught options as often as possible, and avoid larger predatory species to reduce your risk of mercury contamination. And, of course, you can eat free range chicken and pastured pork as often as you like. Both are good sources of healthy protein and fat. One Final Tip… Sugar is a national pastime—an addiction that may be more profound than alcohol, nicotine, or coffee. Interestingly, these four substances also happen to be the top four selling “food items” in the marketplace today. The only way we’re going to break this trend is if we work together to change our food culture, and get sugar off our brains once and for all. So my final tip is simply this: Don’t buy fives boxes of Twinkies for $500. In fact, when another corporate entity buys the Twinkie recipe, don’t buy the snack cake from them either. Instead, be attentive. Become mindful. Look around at the food choices that are out there today. How many of them truly support your brain and body health? When you begin to realize just how much sugar is in the average convenience store today, it’s a little like walking through the looking glass—it’s a world where everything is upside down. The only difference is that the foods stop whispering, “Eat me,” and sing a song of sickness and ecological catastrophe instead. But there is a bright light. It’s a wonderful time to be part of the health and wellness movement in this country, and together we can sing a different song—one about health and ecological wholeness. Hostess 10 closed partly because Americans are beginning to be more aware of the kinds of foods they put in their body. They are beginning to realize that their grandmothers were right all along: “You are what you eat.” Put your dollars toward healthy food choices that support your body, your brain, and our world. Change starts with you and your brain. Feed it what it needs to thrive, and get sugar off your brain for good. References i
Lenoir M, Serre F, Cantin L, Ahmed SH. Intense sweetness surpasses cocaine reward. PLoS ONE. 2007 2(8): e698. doi:10.1371/journal.pone.0000698. ii
Cordain L, et al. Origin and evolution of the Western diet: health implications for the 21st century. Am J Clin Nutr. 2005. 8(2):341– 54. Review.
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United States Department of Agriculture. Agriculture Factbook Chapter 2: Profiling Food Consumption in America. 2001. Accessed online (http://www.usda.gov/factbook/chapter2.pdf ). iv
T, Ohara, Y. Doi, T. Ninomiya, et al. Glucose tolerance status and risk of dementia in the community: the Hisayama study. Neurology. Vol. 77. Sept. 20, 2011, 1126–1134. v
Molteni R, Barnard RJ, Ying Z, et al. A high‐fat, refined sugar diet reduces hippocampal brain‐derived neurotrophic factor, neuronal plasticity, and learning. Neuroscience. 2002. 112(4):803‐14. vi
Yaffe, K, Blackwell T, Kanava AM, et al. Diabetes impaired fasting glucose and development of cognitive impairment in older women. Neurology. 2004. 63: 658–663. vii
Dhamoon MS, Noble JM, Craft S. Intranasal insulin improves cognition and modulates beta‐amyloid in early AD. Neurology. Jan 20, 2009. 72(3):292‐3. viii
Moore, S.C., Carter, L.M., van Goozen, S. Confectionery consumption in childhood and adult violence. The British Journal of Psychiatry 2009. 195: 366‐367. ix
Liu, S, Manson, J, Buring, J, et al. Relation between a diet with a high glycemic load and plasma concentrations of high‐sensitivity C‐reactive protein in middle‐aged women. Am J Clin Nutr. March 2002. 75(3): 492–498. x
Zunszain PA, Hepgul N, Pariante CM. Inflammation and depression. Curr Top Behav Neurosci. May 3, 2012. Epub ahead of print. xi
Dong, J‐Y., Zhang, L., Zhang, Y‐H. Dietary glycaemic index and glycaemic load in relation to the risk of type 2 diabetes: a meta‐analysis of prospective cohort studies. British Journal of Nutrition. December 14 , 2011. 106 :1649‐1654. 11 Authors Daniel G. Amen M.D. Physician: Child/Adolescent/Adult Psychiatry, Nuclear Brain Imaging CEO: Amen Clinics, Inc., San Francisco and Newport Beach, CA, Bellevue, WA and Reston, VA Dr. Amen is a physician, double board certified psychiatrist, teacher and five time New York Times bestselling author. He is widely regarded as one of the world’s foremost experts on applying brain imaging science to everyday clinical practice. Dr. Amen is the Founder of Amen Clinics in Newport Beach and San Francisco, California, Bellevue, Washington, Reston, Virginia, Atlanta and New York City. The Atlanta and New York locations will be opening later this year. Amen Clinics have the world’s largest database of functional brain scans relating to behavior, totaling 73,000 scans on patients from 90 countries. Dr. Amen is a Distinguished Fellow of the American Psychiatric Association and he is the lead researcher on the world’s largest brain imaging and rehabilitation study on professional football players. His research has not only demonstrated high levels of brain damage in players, he also showed the possibility of significant recovery for many with the principles that underlie his work. Together with Pastor Rick Warren and Drs. Mark Hyman and Mehmet Oz, Dr. Amen is also one of the chief architects on Saddleback Church’s “Daniel Plan,” a 52 week program to get the world healthy through religious organizations. After the first year the church lost 260,000 pounds, but weight loss was only one of the stunning side effects of getting truly healthy. Other common effects of The Daniel Plan were increased energy, better focus and mood, and a reduction of many medications for the participants. The Daniel Plan is now being exported around the world to help churches, synagogues and all religious people get healthy. Dr. Amen is also the host of 6 popular shows about the brain, which have raised more than 40 million dollars for public television. 12 Dr. Amen is the author of 51 professional articles, five book chapters, and over 30 books, including five New York Times bestsellers, including Change Your Brain, Change Your Life, Magnificent Mind At Any Age, Change Your Brain, Change Your Body, and Use Your Brain to Change Your Age. In February 2013, Crown will publish Dr. Amen’s upcoming book, Unleash the Power of the Female Brain. Tana Amen, BSN, RN Tana Amen is a nurse, health and fitness expert, and nationally renowned speaker. She shares healthy eating tips and answers questions from The Amen Solution online community via her blog on www.AmenClinics.com. She has been quoted in AARP Magazine, been a guest author for GNC LiveWell Magazine, and appeared on Sirius XM's Martha Stewart Living Radio, ABC's Recipe Rehab and Food and Wine with Chef Jamie Gwen on Southern California's KFWB talk rado. Tana also coaches clients, and has written and self‐published three cookbooks and coaching guide which together have sold more than 80,000 copies Tana is married to New York Times bestselling author Dr. Daniel Amen. 13