Carbohydrate craving by alcohol-dependent men during sobriety: relationship to nutrition and serotonergic function.
BACKGROUND
Several studies report reduced serotonin (5HT) in alcohol-dependent subjects. Furthermore, alcohol increases 5HT in animals. Thus, alcohol dependence may be an attempt to self-medicate reduced 5HT. Relevant to this, reducing 5HT increases carbohydrate intake, and several studies report increased carbohydrate intake in alcohol-dependent subjects. Like alcohol, carbohydrate increases 5HT. We hypothesized that a subgroup of the alcohol-dependent population self-medicates reduced 5HT with alcohol and alternatively with carbohydrate when not drinking.


METHODS
Three groups were recruited: a high carbohydrate craving alcohol-dependent group (n = 10), a low carbohydrate craving alcohol-dependent group (n = 11), and a nonaddicted control group (n = 12). All groups were placed on a high-carbohydrate, low-protein diet for 2 days and then a high-protein, low-carbohydrate diet for 2 days. The effects of diet on mood, alcohol craving, stress, and 5HT were measured.


RESULTS
Although both alcohol-dependent groups had similar alcohol cravings at baseline, only the carbohydrate-craving alcohol-dependent group craved alcohol significantly more when under the stress of the research protocol. The carbohydrate-craving alcohol-dependent subjects presented with distinct personality disorders and were uniquely sensitive to the adverse effects of carbohydrate on mood. Diet had a unique effect on 5HT in the high carbohydrate craving alcohol-dependent group. The results of platelet 5HT uptake demonstrated that the high-protein, low-carbohydrate diet significantly increased Km values of high carbohydrate craving alcohol-dependent subjects, whereas it reduced the Km values of both non-carbohydrate-craving alcohol-dependent subjects and nonaddicted controls.


CONCLUSIONS
Carbohydrate-craving alcohol-dependent subjects are a distinct subgroup of the alcohol-dependent population.
Moorhouse
M
M
Addiction Program, Royal Ottawa Hospital, Ontario, Canada.
Loh
E
E
Lockett
D
D
Grymala
J
J
Chudzik
G
G
Wilson
A
A
D000328:Adult; D000339:Affect / Q000502:physiology*; D000437:Alcoholism / Q000378:metabolism* / Q000523:psychology; D000704:Analysis of Variance; D016739:Behavior, Addictive / Q000378:metabolism* / Q000523:psychology; D004040:Dietary Carbohydrates / Q000378:metabolism*; D004044:Dietary Proteins / Q000378:metabolism; D006801:Humans; D008297:Male; D008875:Middle Aged; D009752:Nutritional Status / Q000502:physiology; D012701:Serotonin / Q000378:metabolism*; D013695:Temperance / Q000523:psychology
D004040:Dietary Carbohydrates; D004044:Dietary Proteins; D012701:Serotonin