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Sugar 101, Or What is a Carb and Why Am I Addicted?

by Michael Cheikin MD

Taste began when the first single-celled organisms needed to detect good and bad molecules in the environment. Our responses to certain tastes and smells, while encoded in the genes, are also programmable. Candy, cake, ice cream and cotton candy on happy occasions since youth program an emotional reaction to sugar. Without sugar, we are unhappy.

Sugar's power is based on its effects on our brain--its sweetness makes us feel good. Sugar is defined as a carbohydrate that tastes sweet. Back in the day, we starved each winter. During the summers, we were rewarded by ingesting sugars (such as fruit) that we would store as fat for the winter.

In the 1950's scientists were leading us into a "fat is bad" era. Atkins' work in the 60's demonstrated that carbohydrates can be worse than fat! While wrong is some ways, Atkins was right that carbo-hydrates are a problem.

Ask someone purchasing a low-carb product "what is a carb"; and the typical answer will be "something that I am willing to pay more to get less of". That answer benefits the food industry, but not those seeking optimal health.


The major building blocks of food, or macro-nutrients, are proteins, fats and carbohydrates. Sugars are (typically) carbohydrates that taste sweet. There are also sweet-tasting molecules that are not carbohydrates, such as glycine, an amino acid, xylitol, an alcohol, and aspartame, a peptide.

Carbohydrates, assembled like building blocks, mostly start with simple mono-saccharides. Two are combined to form di-saccharides such as sucrose (table sugar) and lactose (milk sugar), and then larger structures (polymers) which include starches, fiber and other more complex molecules.

Carbohydrates combine with proteins and other molecules to form hybrids that are used for structure and signaling. The delicious rigid crust of bread is made by the interaction between sugar and protein. That rigidity is what allows trees to stand tall, and what damages the walls of our blood vessels when blood sugar is high, especially in diabetes. The stickiness of certain sugars, similar to caramel, within our bodies contributes to cataracts and other diseases (see "glycation"" in table).

Sugar Processing

A delicious pastry, even before it touches our tongue, causes our brain to prepare for the sugar load by mobilizing certain powerful chemicals including dopamine and insulin.

Dopamine is a major feel-good neurotransmitter (signal molecule used by nerve cells) that activates our brain's pleasure center. Dopamine is a key to addictions, including food, nicotine, opiates, cannabis, gambling and sex. Rats given a choice between opium and sugar chose sugar. Recovered addicts are often addicted to sugar.

Insulin is one of many hormones that manage carbohydrate levels in our body. It is released by the pancreas in proportion to the carbohydrates in our diet. Insulin moves glucose into our cells, including fat and liver cells. Diabetes is a medical condition in which the insulin response is initially too high (diabetes type 2) or too low (juvenile diabetes or type 1) Diabetes drugs alter insulin release or receptors.

When we eat sugars in ways that did not occur during evolution, such as cereal for breakfast, high-fructose corn syrup in processed foods and even pineapple in the winter, the confused responses eventually lead to imbalances in dopamine, insulin, and other molecules. Certain yeasts and bacteria naturally occurring in our gut can be over-fed by sugar, producing toxic waste products and signal molecules that cause further carbohydrate craving.

Where to Start

Like fat, carbohydrates are not inherently good or bad. However, we confuse our brains and metabolisms in the way we eat sugar. One definition of addiction is "who's in charge", "I want more" or "I can't stop". If sugar is in charge of your life, then the first step is to recognize its power. Next is to get educated and formulate a strategy to gradually and persistently change lifestyle. A knowledgeable practitioner can help during the difficult times.


1. This educational material may not be used to influence medical care without supervision by a licensed practitioner.

2. These contents are ©2015-18 by Michael Cheikin MD and may not be reproduced in any form without express written permission.

3. Dr. Cheikin's website has related articles such as “Carb Misuse," "Sugar Blues," "Weight Loss Resistance" and many others.

Michael Cheikin MD is a holistic physician, Board Certified in Physical Medicine and Rehabilitation ("Physiatry"), Pain Management, Spinal Cord Medicine and Electrodiagnostic Medicine and licensed in Medical Acupuncture. Dr. Cheikin has extensively studied yoga, diet and metabolism, Ayurvedic, Chinese and energy medicine and other alternative modalities for over 35 years. He specializes in obscure, chronic and severe problems that have not responded satisfactorily to other methods of healing. www.cheikin.com

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