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Trauma at the Table: Why Kids in Care Have Food IssuesM O N ICA SM IT H, M A , RD
CO U N SEL ING A N D N U T RITION SE RVICES , LLC
IA M RD@SBCGLOBA L.NET
W W W.FOODA NDMOODCOUNSEL ING.N ET
The Focus1) Understand some of the eating behaviors commonly seen in individuals dealing with trauma
2) Develop a basic idea of how food affects our response to stressors
What is Trauma?
A Broad (and realistic) View of Trauma
How Prevalent is Trauma?
Food and Trauma Go Hand In Hand80% of the 49,408 participants in the Nurses’ Health Study II reported at least 1 traumatic exposure.
There are 13,000 children currently in foster care in Michigan. An estimated that 1 million children in the US suffer maltreatment yearly.
Consider survivors of car accidents, home fires, bankruptcy, chronic illness….
It is highly unlikely that the children you are serving are living in a home that has been sheltered from trauma. Even if it is a good home.
How is Food Related to Trauma?
Ever Heard of Emotional Eating?8% (or ~3200) of the participants from the Nurses’ Health Study II who reported at least 1 traumatic experience met the criteria for food addiction.
BMI increases for 35% of all children entering foster care.
27% of all children in foster care are obese – compared with 17% of children in the general population.
A literature review found that adults who suffered childhood maltreatment were associated with increased levels of C-Reactive Protein, fibrinogen and pro-inflammatory cytokines (physiological markers of inflammation and heart disease). A lifetime of being undiagnosed and untreated…..
Sugar and Trauma
Trauma depletes the neurotransmitter dopamine (DA). This means that trauma survivors will have a hard time feeling pleasure
Trauma also increases the release of
norepinephrine. The fight or flight neurotransmitter.
The symptoms of the impulsive and anxious kid who is living with
trauma can mimic ADD…
Sugar and simple carbohydrate increase
the release of DA, which feels very pleasurable to a person who otherwise
is feeling down.
Daily intermittent use of sugar maximizes the release
and the response to DA.
12 hours of no use (sleeping) then frequent use over the next 12 hours (soda, candy,
any kind of simple carb) will give the
highest pleasure response.
The amount of sugar necessary to achieve a DA
response that will alter brain chemistry must continually
increase unless there is a significant period
of abstinence.
This period ranges from days to weeks,
depending on the individual.
Alcohol and Trauma
There is a known cross sensitization between alcohol and sugar. This means those people who crave and use sugar to feel better
are more likely to crave and use alcohol to feel better.
Kids who age out of care often find themselves homeless,
incarnated or addicted.
The earliest detector of inability to cope is not
alcohol use. It is more likely sugar addiction.
Alcohol is trauma’s second “food” of choice.
Sugar is first.
Bingeing, Purging and Trauma
As individual reaches satiety, Acetylcholine (ACh) is
released, this causes DA to plummet. Depression follows.
This mimics the effects of opiates….
If the kid purges, DA levels remain higher, longer.
If a high sugar food is added, even if the kid is beyond full, the DA response increases.
This prompts bingeing – especially on high sugar foods.
Coping is often the primary motivator in bulimia and bingeing. This behavior
is saying “I need to feel better.”
The Body’s Response To Medicating With Food
Inflammation and Response to StressorsSugar heightens the inflammatory response.
When the inflammatory response is high, depression and anxiety can be intensified. The development of mood disorders can also be perpetuated by the presence of high C-Reactive Protein and Cytokines.
Effectiveness of anti-depressant and anti-anxiety medications may be affected when CRP is elevated.
Possible behaviors associated with heightened inflammation are cognitive disturbances, fatigue, being unable to find pleasure, social withdrawal, and a
heightened sense of pain
Females have a greater inflammatory response than do males, thus there
may be a greater tendency for females to report aches, pains and
general malaise or unhappiness
Putting the Pieces Together.Trauma Depletes dopamine, increases norepinephrine
and depletes Thyroid Simulating Hormone
Sad, inconsolable, impulsive and overweight
Vitamin D StatusOften starts low, contributes to depressed
mood
Sugar and StressLow Dopamine = Increased desire for sugar
The more sugar you eat, the more you need
Sugar and InflammationSugar + Stress = increased inflammation
Mood and InflammationIncreased inflammation + Low Vit D further perpetuates depression and anxiety. Reduces ability to respond to stressors. Increases “sickness behaviors”. Lessens the effectiveness of mood medications
Looking at Trauma From a Nutrition Perspective
Common and Early Warning SignsEating more, eating less
Significant and unexplained or unintentional weight gain or weight loss
Restricting, bingeing and/or purging as a way to numb or feel betterOnset of eating disorder is a common response after traumatic event,
especially in adolescents, but rarely discovered until years later.
Hoarding Children who hide food, obsess about food, eat uncontrollably, or steal food
are often suffering neglect or maltreatment, or have been traumatized in the past.
Suggestions
Avoid using sugar as a way to help your child feel better Instead of going for ice cream, go to the park, bowl,
draw, talk, play a game… Allow your child to feel what they are feeling.
Acknowledge it without trying to fix it.
When your child is inconsolable, don’t take it personally It probably isn’t you or what you are trying to do for
or with your child. It is more likely brain chemistry.
Look at weight fluctuations as a sign of possible ongoing trauma – especially if there is a rapid onset. Ask about eating behaviors. What has changed? Why? If your child is underweight, discourage food
substitutes such as Ensure and Boost.
America’s #1 Food Substitute
Water, Sugar, Corn Maltodextrin, Milk Protein Concentrate, Soy Oil, Short Chain Fructooligosaccharides, Soy Protein Isolate, Canola Oil. Less than 0.5% of: Corn Oil, Magnesium Phosphate, Potassium Citrate, Cellulose Gel, Natural & Artificial Flavor, Salt, Calcium Phosphate, Sodium Citrate, Calcium Carbonate, Potassium Chloride, Choline Chloride, Ascorbic Acid, Cellulose Gum, Monoglycerides, Soy Lecithin, Carrageenan, Potassium Hydroxide, Ferrous Sulfate, dlAlpha Tocopheryl Acetate, Zinc Sulfate, Niacinamide, Manganese Sulfate, Calcium Pantothenate, Cupric Sulfate, Vitamin A Palmitate, Thiamine Chloride Hydrochloride, Pyridoxine Hydrochloride, Riboflavin, Folic Acid, Chromium Chloride, Biotin
ick.
If your kid is struggling with depression, anxiety, impulsivity or weight gain, advocate for a physical that includes blood work for TSH, Vit D, CRP.
If your kid is on multiple mood medications, or the levels continue to need to be increased, advocate for a physical that includes bloodwork for CRP and Vitamin D level
If your kid is in trouble at school, or is on medication for ADD, advocate for a physical that includes bloodwork for CRP and Vitamin D level
I Know You Can’t Do It AllBUT YOU CAN, AND WILL, DO SOMETHING .
Because We Are
