Intelligent Medicine | The Best of High Tech Medicine and Alternative Modalities

Nutritionist Leyla Muedin discusses a listener question about whether agave nectar can contribute to obesity like high-fructose corn syrup, arguing that regular use of sweeteners—including agave, honey, monk fruit, stevia, aspartame, sucralose, allulose, and sugar alcohols—can maintain sweet cravings, spike insulin, and contribute to weight-loss plateaus, with added concerns such as microbiome effects, GI upset, and aspartame’s neurotoxicity. She notes insulin’s role in fat storage and blood pressure via sodium retention, and suggests that needing a sweetener in coffee or tea may indicate dependence on sweetness. She then covers a newly developed, validated Food Noise Questionnaire (FNQ) published in Obesity to measure intrusive food-related rumination, highlighting its five Likert-scale items, study sample characteristics, and the need for further research, including effects of GLP-1 drugs.

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Sugarless: Dr. Nicole Avena on Hidden Sugars, Brain Addiction, and Practical Steps to Cut Back: Neuroscientist and author Dr. Nicole Avena reveals sugar’s pervasiveness and health impacts, drawing on her book “Sugarless: The Seven-Step Plan to Uncover Hidden Sugars, Curb Your Cravings, and Conquer Your Addiction.” Avena explains how modern industrialized, highly processed foods—many containing added sugars—have transformed innate preferences for sweetness into harmful overconsumption linked to obesity, diabetes, cardiovascular disease, non-alcoholic fatty liver disease, and possible dementia via insulin signaling changes. She discusses research showing sugar can stimulate dopamine reward pathways similarly to drugs and that prenatal exposure may alter offspring metabolism, preferences, and sensitivity to drugs/alcohol. For solutions, she discourages strict “cold turkey” approaches due to hidden sugars and relapse psychology, emphasizes inventorying sources and triggers, starting with eliminating sugar-sweetened beverages and sugary coffee drinks, improving breakfast, choosing protein/fat-based snacks, and viewing alternative sweeteners as a temporary crutch; she also notes diet changes can improve mood stability and reduce anxiety.

Dr. Hoffman continues his conversation with neuroscientist and author Dr. Nicole Avena.