askjoel

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HI I AM 8 WEEKS PREGNANT AND HAVE BEEN STRUGGLING WITH QUITTING FOR SOME TIME, EVEN BEFORE THE PREGNANCY I WAS TRYING TO QUIT. I ALSO HAVE ANXIETY THAT I AM IN COUNSELING FOR. THE SCARIEST PART FOR ME IS THE ANXIRTY THAT QUITTING CREATES. MY QUESTION IS IS IT DANGEROUS TO GO THROUGH WITHDRAWAL CT WHEN PREGNANT AND DOES DRINKING JUICE REALLY CUT DOWN THAT LOW BLOOD SUGAR FEELING. IF SO HOW MUCH SHOULD I DRINK. I REALLY WANT THIS SO BAD THANKS

COLLEEN

From the string Pregnancy and smoking

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Message 1 of 68 in Discussion

From: Joel. (Original Message)

Sent: 6/7/2001 7:24 AM

I saw yesterday where one member stated she was quitting smoking because she was planning for having a child and another post where a member actually found out she was pregnant. While it is always paramount for long-term success in smoking cessation that the smoker focuses on the fact that he or she is quitting for his or her own primary benefit, this is an area that a woman needs to take a little extra consideration for another life.

There are great risks posed to the unborn child if women smoke while pregnant. There is a greater risk of smaller babies, sicker babies, stillbirths, and more death within the first year of life. Children who grow up in smoking households have more chronic colds and respiratory diseases.

I haven't researched this area for quit sometime, but I know years ago that there were some pretty strong studies that showed that if women quit smoking during the first trimester of pregnancy, the risk of low birth weight babies were reduced back to non-smoking mothers again. It seemed at least at that time that a good part of the danger was induced smoking past that time period.

It is important for women who are in the stage of their lives of family planning take their smoking into consideration. The idea of just quitting to get pregnant or having a baby can pose a risk after the baby is delivered. You can figure now that the risks are now gone, you quit for the important time period. But still keep in mind that even though you did your baby a favor by quitting, you really did yourself the bigger favor.

For not only did you reduce the risk to your baby, you reduced your risk of being sicker throughout your life and eventually dying prematurely--you increased your ability to be active with your baby, throughout his or her life, even when your baby becomes an adult. You increased the odds that you will be around to see your baby eventually have children of his or her own, and even then you can be an active participant in yet another generation, as opposed to an elderly person on oxygen who watches family events from the sidelines, if you can even go to see them at all.

Quitting for pregnancy is a reason to start your quit. Staying off though is more comprehensive than this. There are many other benefits that go along with staying an ex-smoker that will stick with you throughout your entire life. To keep these benefits, always remember that the best way to improve "your" overall health and quality of life is to never take another puff!

Joel

Here is a link to the CDC fact sheet on smoking and pregnancy. There are plenty of other sites that I am sure have similar information too. I just went for the first one that popped up in a search engine.

From: Joel

Sent: 2/26/2006 6:25 AM

As far as I know there has never been any credible research done that had proved that quitting cold turkey was too dangerous. I actually haven't even had the question posed to me for many years.

There was a time when I used to get the question quite frequently. In my early years of doing programs I would hear it from people who told me that they had personal physicians who would tell them that quitting was just too much of a shock to their system and not worth the risk. It was often advice given to pregnant women by their obstetricians.

What must be understood about this information is was what the level of total misunderstanding there was by the physicians at the time, as well as by the entire medical and scientific community. It was at a time that there was a good chance that if a woman were to ask her physician if smoking was harmful to her baby, that the physician could have reached into his shirt pocket, pulled out a cigarette, took a few puffs while in deep contemplation and came back with the answer that smoking didn't really pose any real risk. The same kind of conversation could have been held between a man and his cardiologist or any person with almost any medical condition talking to his or her doctor. Back in the 1950's over half of the doctors in our country smoked.

What we know now about the dangers of smoking as it relates to many conditions makes it totally obvious to almost any health care professional in any field that smoking is deadly, even though in the past the lack of solid information caused the wrong advice to be standard fare.

We now have decades of experience with millions and millions of people successfully quitting smoking, the vast majority of them doing so by going cold turkey. It should be obvious to almost any one now that the dangers of quitting smoking is not what smokers need to be concerned with, it is the dangers they face if they do not quit smoking.

On a personal note, I have personally run over 4,500 people through cold turkey smoking programs for almost 30 years now. Out of those 4,500 people I only had two people who died during the two week period of the clinic. One was a younger man, probably in his thirties with severe heart disease and diabetes who was forced into the program by his wife and doctor because it was clear to both of them that he was in real danger of dying if he didn't quit smoking. Unfortunately, while the man's wife and doctor were both convinced that he was in immediate danger, the man himself didn't accept the risk for in fact, he did not quit smoking during that clinic. He was cheating throughout the program and his wife was not ever sure he had reduced his smoking at all from the first day of the program. He died on the fifth or sixth day.

The other death was from a man who was also in really bad shape, having just had major cardiac surgery, was still having ongoing problems with chronic heart failure and had a terrible prognosis coming in. His doctor had told him that he was a walking time bomb and he meant it in very literal terms. He died about ten days into the program. He had quit and had eased up in the withdrawal, was in fact very proud of the fact that he had quit and was happy with his decision to do so. I actually went to his funeral. His wife was very happy to see me there, and excitedly introduced me to a number of their family members and friends, explaining how I was the person who helped her husband to quit smoking. They were all very proud of the man and felt that he really was trying to give himself a fighting chance to live. That seemed very important to his loved ones at that time.

Other than these two cases, I have never encountered a person who had died during the quitting process, which is quite remarkable considering the state of health that many people who come to clinics are in.

Again, don't waste your energy on the fear of quitting. It is a baseless fear. If you spend time doing any real research on the effects of not quitting though, the fear that you will feel will be totally warranted for the magnitude of risk posed by smoking is tremendous. The good news is that all of the risks posed by smoking can be minimized by simply making and sticking to a personal commitment to never take another puff.

Joel

Joel's Reinforcement Library

I Have to Smoke
Because of All My Stress!

Stress is considered a cause for smoking by many people. Actually, smoking is a cause of stress. Recent correspondence dealt with reasons people give for going back to smoking: social situations, parties, alcohol consumption and stress. This month I wish to amplify on stress.

In January of 1979, Chicago and vicinity was devastated by a major blizzard. Heavy snows fell just after the New Year crippling the area. Additional snowfall continued throughout the week. During this time period I was barraged with phone calls from participants of the November, 1978 clinic claiming to be terribly nervous, upset and anxious from "not smoking." Curiously, most of them were feeling well during the month of December. They had occasional urges which lasted only seconds and were quite easy to overcome. What they were experiencing in January was different. Many felt that they were on the verge of cracking up. To them life was "just no good" without their cigarettes. Was the anxiety they were now experiencing really a side effect from giving up smoking?

To any outside observer the answer to the mysterious intensification of perceived withdrawal was obvious. In fact, if our ex-smokers listened to radio or television or read the front page of any newspaper, they would have encountered a story on cabin fever. By simply comparing their symptoms with those accompanying cabin fever they would understand what was happening.

Attributing the anxiety to smoking cessation was transference of blame. In fact, they were having a normal reaction to an abnormal situation - confinement due to the blizzard. They would have had the same anxiety whether or not they had given up cigarettes.

The above story illustrates an atypical time period in which numerous people experience similar complaints. In everyday life inherent problems exist. Work, family, friends, and money can all contribute to daily distress. Ex-smokers often think that if they just take a cigarette during a stressful episode the situation will be solved. For example, consider a person who finds he has a flat tire in a parking lot during a freezing rain. When encountering this kind of misfortune, the ex-smoker's first reaction often is, "I need a cigarette." What will actually solve this problem is changing the tire, and driving off in a warm car. What would a cigarette do to help this situation? It only makes the person see the flat tire longer and freeze more. This adds up to greater frustration. The first puff will probably reinforce the addiction to cigarettes which is a much greater crisis than the flat tire ever was. In fact, taking the first puff almost always results in a bigger problem than the crisis that "caused" them to take the puff. Even in a real catastrophe, such as a death in the family, injuries, illnesses, flooding resulting in major property loss, bankruptcy and so on, a cigarette will not solve the problem. It will just add another major problem to the originally bad situation.

Remember, smoking cannot solve problems of daily living. No matter what the problem, there is a more effective way of solving it than smoking. In fact, a smoker's health risks are a real problem that can only be solved if they - NEVER TAKE ANOTHER PUFF!

From: Joel

Sent: 12/23/2005 6:31 AM

From the Kansas City Star
August 16, 2003

One more reason to stop smoking - panic attacks

Don't panic -- stop smoking.

A new study suggests that panic attacks are far more likely in nicotine addicts than nonsmokers.

In surveying more than 3,000 Munich-area teenagers and young adults, researchers from Germany and California found that 7.6 percent of regular, nicotine-dependent smokers had a history of panic attacks.

That compares with 0.7 percent of nonsmokers, 2 percent of occasional smokers and 1.9 percent of regular smokers who weren't nicotine-dependent.

The scientists report a similar pattern for subjects who met diagnostic guidelines for panic disorder, a condition marked by recurrent panic attacks, fear about future attacks and worries about their consequences. A history of other psychiatric illnesses couldn't account for the associations, the researchers write this month in Archives of General Psychiatry. Four years later, nonsmokers were less likely than dependent smokers to have developed panic ills.

Here is an abstact of the study being discussed.

From the Archives of General Psychaitry

Vol. 60 No. 7, July 2003

Smoking Increases the Risk of Panic
Findings From a Prospective Community Study

Barbara Isensee, PhD; Hans-Ulrich Wittchen, PhD; Murray B. Stein, MD; Michael Höfler, DiplStat; Roselind Lieb, PhD

Arch Gen Psychiatry. 2003;60:692-700.

Background We examined prospectively determined bidirectionalassociations between smoking and panic and other anxiety disordersand their temporal ordering of onset in a representative communitysample of adolescents and young adults.

Methods Baseline and 4-year follow-up data were used fromthe Early Developmental Stages of Psychopathology Study, a prospectivelongitudinal study of adolescents and young adults in Munich,Germany. We assessed smoking (occasional and regular), nicotinedependence, panic attacks, panic disorder, other anxiety disorders,and other mental disorders using the Munich-Composite InternationalDiagnostic Interview.

Results At baseline, panic attacks and panic disorderwere strongly associated with occasional and regular smokingand nicotine dependence (odds ratio [OR] range, 3.0-28.0). Inthe prospective analyses, we found increased risk for new onsetof panic attacks with prior regular smoking (OR, 2.9; 95% confidenceinterval [CI], 1.0-8.4) and nicotine dependence (OR, 3.6; 95%CI, 1.2-10.5). Prior nicotine dependence increased also therisk for onset of panic disorder (OR, 3.3; 95% CI, 1.0-10.5),whereas preexisting panic was not associated with subsequentsmoking or nicotine dependence. When using Cox regression withtime-dependent covariates, prior nicotine dependence was confirmedto be related to subsequent panic attacks (hazard ratio, 2.7;95% CI, 1.7-4.2), but not panic disorder (hazard ratio, 1.7;95% CI, 0.7-3.9). Rather, we found indications that prior panicattacks/disorder might also have an effect on secondary developmentof nicotine dependence.

Conclusions In young adults, prospective analyses revealeda fairly unique and specific, unidirectional relationship betweenprior smoking and increased risk for subsequent panic attacks/disorder.However, we could not exclude the existence of a second, lessfrequent, reverse pathway of prior panic and secondary nicotinedependence.

From the Clinical Psychology and Epidemiology Unit, Max-Planck-Institute of Psychiatry, Munich, Germany (Dr Isensee, Wittchen, and Lieb and Mr Höfler); the Department of Psychiatry, University of California–San Diego, La Jolla (Dr Stein); and the Department of Clinical Psychology and Psychotherapy, Technical University of Dresden, Dresden, Germany (Dr Wittchen and Mr Höfler).

From: Joel

Sent: 1/14/2006 6:21 AM

While most smokers actually believe that smoking was an effective stress treatment strategy (a drug that calmed them down), when it really comes down to it, smoking never truly calmed them down. All it did was administered nicotine alleviated nicotine withdrawal that was induced by stress. The illustration and text below covers this point.

The one true step that people are doing here to control their stress is getting rid of a product that should cause any thinking person a lot of worry and to stop the vicious cycle of drug feeding and drug withdrawal by always knowing now to never take another puff!

Joel

In the illustration above you can see on the left how a non-smokers reacts to stress. Without it they are happy and comfortable, when encountering stress they lose this comfort and depending on its severity they can get either mildly annoyed or really upset. The resolution of the stress will normally bring the non-smoker back to the original state of comfort, after a little time of cooling down of course.

Smokers are much more complex. Stress has an affect on all people--it makes the urine acidic. Both smokers and non-smokers experience this phenomena. In non-smoker smokers, the urine acidity has no real visible or perceivable effects--smokers are much more complicated. After the initial stress a smoker will feel like a non-smoker encountering stress, for a few seconds. But then the delineation occurs, the smoker's nicotine level depletes because of the urine acidity induced by the stress, and the smoker is kicked into a drug withdrawal state. The smoker has four ways to deal with the situation now.

First, the smoker can just smoke a cigarette. Well low and behold if the smoker does this he or she will feel "better." He or she will not feel good; he or she just won't be feeling withdrawal for the moment but still be feeling the initial stress. In essence, he or she will feel like a non-smoker under stress, not great, but not in withdrawal either.

The second way a smoker can handle the stress is to solve it and also smoke a cigarette. This results in one happy smoker. No stress now and no withdrawal, life is good at the moment. The feeling of bliss is basically the same feeling a non-smoker has who resolves his or her stress.

But then there are the other two scenarios. The smoker can solve the problem but not smoke. Here is the kicker here, the problem is resolved but the smoker is still in withdrawal, the nicotine level has dropped and problem resolution has no way to stop the nicotine depletion, only a cigarette can do that.

The worst of all situations is the smoker who cannot solve the problem and also cannot smoke a cigarette. This is a miserable situation to ever be in. You normally don't want to be around a smoker in this situation let alone being one yourself. Many smokers find themselves facing this dilemma daily since many jobs and social settings do not allow smoking yet constantly force the smoker to face stresses.

When you quit smoking these last four reactions to stress become a thing of the past. You still face stress, but you no longer have to face drug withdrawals induced by it. In essence you deal with stress in a totally different way when you don't have chronic drug withdrawals exaggerating it.

To stay in the position of being able to handle stresses with greater clarity and minimal discomfort always know that no matter what the stress, to avoid it having any long lasting and life threatening complications always remember to never take another puff!

Joel

Joel's Reinforcement Library

How would you deal with

the following situations?

Your 2-year-old is having a temper tantrum because he wants a new toy. Would you;

Leave him alone until he calmed down

Give into his demands

Give him a tranquilizer

Your 7-year-old is anxious about next weeks' Little League tryouts. Would you;

Assure him that he can do it

Practice with him and tell him to try his best

Give him a valium every three hours until the game

Your 14-year-old is crushed when she is not asked to the sophomore dance. Would you;

Fix her up with one of your friend's children

Tell her to go anyway

Give her cocaine to pick up her spirits

Your 15-year-old is self-conscious about being 5 pounds overweight. Would you;

Cook lower calorie meals

Enroll her in a diet or exercise program

Put her on appetite suppressants

All of these young people are experiencing what adults would consider "growing pains." A little time, patience and positive reassuring will help them overcome all of these difficult situations.

The fact is, as long as anyone continues to develop physically, emotionally, intellectually, professionally or spiritually, they too will experience growing pains. Adults are prone to hurt, pain, sadness, depression and anxiety just as children are. These feelings are all necessary if we wish to continue to develop our minds and bodies. Without such growth, we would not experience happiness, satisfaction, contentment or purpose to their full extent.

The third choice in each of the above situations was, of course, ridiculous. We would not subject our children to chemical hazards to overcome such trivial problems. However, as adults we are fully capable of practicing such dangerous behaviors for our own relief. Take cigarette smoking as an example.

When you were still a smoker, how many times would you say you had to smoke because you were lonely and sad without your friendly cigarettes? How many times did you say that you had to smoke because of all the stress in your life? How many times did you tell yourself that many social activities were just not fun without your cigarettes? How many times did you say that you would gain too much weight if you quit smoking? All you were saying was that you needed nicotine, a drug, to overcome everyday life problems.

It was not until you were off cigarettes that you realized you could overcome such problems without smoking, and in most cases more effectively than when you were a smoker. Once you had quit you realized just how much a source of stress the habit was to you. You were caught by a socially unacceptable and physically deadly addiction and were quite often aware of it. This is when you had the desire to give them up, but thought the pain of quitting too great to even attempt it.

Even today, you probably still desire an occasional cigarette. It may be in a stressful situation, at a party after a few drinks, or at a time when you find yourself alone with nothing better to do. The fact is, there is nothing worse you can do than take a cigarette. One cigarette will not help you over the problem. In reality, it will create a new problem, a disastrous situation of a reinforced addiction, with all the physical dangers and associated dirty habits.

So, next time you have the desire for a cigarette, sit back and take a few moments to reflect upon what you are setting yourself up for. Do you need that drug? Do you want that addiction? If not, simply remember - NEVER TAKE ANOTHER PUFF!

From: John (Gold)

Sent: 6/14/2004 6:23 AM

Other discussions, studies and articles in this thread include ...

Message 2 & Message 3   Quitting during pregnancy sometimes seeming absurdly easy (Joel)

Message 7 Postpartum return to smoking among usual smokers who quit during pregnancy (2001 study)

Message 8, Message 11    NRT during pregnancy (Joel)

Message 13 Smoking, Sex and Reproduction (ASH Fact Sheet)

Message 17 Mothers who smoke may be hearing from colicky babies (2001 news article)

Message 18 Prenatal Nicotine Exposure Evokes Alterations of Cell Structure in Hippocampus and Somatosensory Cortex (2002 study)

Message 24 Nicotinic receptor expression following nicotine exposure via maternal milk (2002 study)

Message 25 Fetal Nicotine Exposure Tied to Breathing Problems (2002 news article)

Message 26 Altered Breathing Pattern after Prenatal Nicotine Exposure in the Young Lamb (2002 study)

Message 27   Smoking Moms Boost Unborn Babies' Autism Risk (2002 news article)

Message 28 When Moms Smoke, Certain Kids Are More Vulnerable to Respiratory Disease; Children With Key Common Genetic Variation Are More Susceptible to Asthma and Other Breathing Problems If Exposed to Tobacco in Womb (2002 news article)

Message 30 Study Suggests Why Cigarette Smoke a SIDS Risk (2002 news article)

Message 36   Joel discussing how quitting for the fetus or baby is not quitting for you.

Message 37 Joel discussing post-partum relapse

Message 38  Dangers of smoking while pregnant need to be emphasized by health care providers (2002 article)

Message 39 A reexamination of smoking before, during, and after pregnacy (2002 study)

Message 42 Many Women Return to Smoking After Pregnancy (2003 article)

Message 47 Study: Smoking During Pregnancy Impairs Fetal Development (2003 article)

Message 54 SIDS prevention--good progress, but now we need to focus on avoiding nicotine (2004 study)

From: John (Gold) (Original Message)

Sent: 6/20/2001 7:24 AM

I ran across the following common sense eating article that I wish I'd read long ago as I apparently had little common sense when it came to feeding my body. We tend to blame our quit for much of what we're feeling when quitting has nothing to do with it at all. I've indexed this under the Weight Gain message board.

How to Maintain Glucose Levels

An extract from Natural Alternatives to Dieting

by Marilyn Glenville, Ph.D.

Almost all dieters have an underlying blood sugar imbalance. Blood sugar can be the most important factor in losing and maintaining a healthy weight. The importance of correcting blood sugar fluctuations to lose weight is emphasised by the title of an article published in the Encyclopaedia of Common Diseases written by the staff of Prevention Magazine; 'Low Blood Sugar Can Make You Fat'.

Blood sugar

Fluctuations in blood sugar can cause:
�?cravings
�?water retention
�?excess thirst
�?mood swings

Moods can swing from euphoric to unhappy; angry to couldn't care less; irritable and anxious to bored and tired. The positive moods can be as dangerous as the negative, because you are likely to swing rapidly from one extreme of mood to the other. You must take control of those highs and lows because the associated food cravings can undermine your efforts to change your eating patterns.

Perhaps you know that you are only overcome by cravings for sweet things at pre-menstrual times. If so, this chapter will later explain how blood sugar levels are connected with our hormones.

Nutrition and blood sugar

Nutrition is the key to stabilising the levels of blood sugar. After a meal, glucose from the breakdown of food (digestion) is absorbed through the wall of the intestine into the bloodstream. At this point, there is, quite naturally, a high level of glucose in the blood. The body takes what it immediately needs for energy and then produces insulin from the pancreas in an attempt to lower the level of excess glucose. Any glucose that is not used immediately for energy is changed into glycogen and stored in the liver and muscles to be used later. The glucose level in the blood then reduces to normal.

How do we maintain glucose levels? To maintain this balance in our blood sugar the body works in a similar way to the thermostat on a central heating system. Our natural 'thermostat' clicks into action as glucose levels rise and fall.

The body takes action in the following ways:

When the glucose levels fall too low

The hormone adrenaline is released from the adrenal glands and glucagon is produced from the pancreas. Glucagon works in the opposite way to insulin and increases blood glucose by encouraging the liver to turn some of its glycogen stores into glucose to give us quick energy. If the blood glucose level stays low for a period of time hypoglycaemia �?low blood sugar level �?can occur.

Symptoms include: irritability, aggressive outbursts, palpitations, forgetfulness, lack of sex drive, crying spells, dizziness, anxiety, confusion, forgetfulness, inability to concentrate, fatigue, insomnia, headaches, muscle cramps, excess sweating and excessive thirst.

Sounds familiar? Chances are that if you have a history of dieting then some or many of those symptoms are known to you. In themselves they can be burdensome, but more importantly they are the outward manifestations that your body is having trouble maintaining a good blood sugar level. They can certainly undermine the efforts of many dieters by triggering unhealthy eating which contributes to weight gain.

When the glucose level rises too high

Insulin is produced by the pancreas to lower it. If the blood sugar level remains too high, this causes the symptoms of hyperglycaemia �?high blood sugar level. The extreme form of this is diabetes which is a medical condition needing expert attention often entailing regular insulin injections. Weight cycling �?weight gain, loss then gain �?may make you more prone to diabetes. Obese people have a 77 times higher chance of developing diabetes than a person at their correct weight �?the greater your weight the higher the risk of developing diabetes.

During a normal day, the amount by which your blood sugar level rises and falls depends on what and when we eat:

What we eat or drink

When we eat any food in refined form its digestion is very fast. Refined foods have been stripped of their natural goodness by various manufacturing processes. Two of the most widely used refined foods are sugar and white flour. When digestion is too fast glucose enters the bloodstream too rapidly. This also happens when you eat any food or drink that causes a stimulant effect, like tea, coffee, sugar and chocolate. This sharp, fast rise in blood glucose makes you feel momentarily good but the 'high' quickly passes plummeting you to a low point, making you feel tired and drained. So what do you need? Another stimulant like a bar of chocolate or cup of coffee (or both!) to give you another boost.

The second boost will cause the blood sugar level to go up rapidly again and the vicious cycle is repeated. As blood sugar levels go up and down so too do our eating patterns with cravings for sweet foods and drinks.

Over time, this constant over-stimulation exhausts the pancreas. Then, instead of too much insulin, it produces too little. Too much glucose stays in the blood, causing the symptoms of high blood sugar levels.

You are advised to eat natural wholefoods which are unrefined and full of goodness. Their merits in terms of helping to maintain balanced blood sugar levels are discussed later in this chapter.

When we eat or drink

If there is a long gap between eating the blood glucose will drop to quite a low level and you will feel the need for a quick boost, say a cup of tea and a biscuit. At the same time, the adrenal glands will make the liver produce more glucose. The combination of these two acts causes high levels of glucose in the blood which again calls on the pancreas to over-produce insulin in order to reduce the glucose levels. The vicious cycle starts all over again and the adrenal glands become ever more exhausted.

To solve this problem try
�?Grazing �?develop a 'grazing' mentality to your eating patterns thus eating little but often. Leave behind the dieting philosophy of no food between meals.
�?Avoid skipped meals �?maybe you thought that if you ate less by missing meals you would lose weight but the resultant swings in blood sugar are setting you up to fail. They create a biological urge that must be satisfied and you shouldn't ignore your body's demands even if you were strong enough.

Make it easy for yourself. If you stop what is causing the biological urge then you won't be constantly at war with your own body.

Table 1: Vitamins for Weight Loss

Vitamin �?B2 (riboflavin)
Function �?Converts fat, sugar and protein into energy. For hair, nails and eyes.
Good sources �?Almonds, wild rice, soya beans, broccoli, wholemeal bread, mackerel, eggs, yoghurt.

Vitamin �?B3 (niacin)
Function �?Essential for energy production, balancing blood sugar, and maintaining cholesterol balance.
Good sources �?Canned tuna in oil, salmon, wholewheat, asparagus, almonds, brown rice

Vitamin �?B5 (pantothenic acid)
Function �?Involved in energy production and regulating fat metabolism.
Good sources �?Wholewheat, alfalfa sprouts, peas, lentils, eggs, mushrooms, brown rice.

Vitamin �?B6 (pyridoxine)
Function �?Aids digestion of protein, and helps maintain hormone balance. Useful for PMS and as an anti-depressant.
Good sources �?Brown rice, cauliflower, grilled herring, soya beans, sweet potatoes, sunflower seeds.

Vitamin �?C (ascorbic acid)
Function �?Required for collagen for healthy bones, skin, and muscles. Vital for immune function. Converts food into energy.
Good sources �?Raw peppers, broccoli, cauliflower, strawberries, peas, baked potatoes, oranges.

Vitamin �?Choline
Function �?Member of B complex family. Required for correct fat metabolism.
Good sources �?Eggs, cauliflower, cucumber, peanuts.

Vitamin �?Inositol
Function �?Works closely with choline. Aids fat transfer from liver.
Good sources �?Soya, eggs, citrus fruits, wholegrains, nuts.

Effects of adrenaline

If blood sugar levels are frequently low and our system is regularly being asked to pump out adrenaline then our health will suffer. Adrenaline is the hormone most of us associate with stress �?it is released for 'fight or flight' and its effect is very powerful. If you were threatened in the street, for example, or face any kind of physical danger your survival mechanisms would instantly step into action with the adrenal glands immediately producing large amounts of adrenaline.

The effects of adrenaline are
�?heart speeds up
�?arteries tighten to raise blood pressure �?hence a 'beating' heart
�?liver immediately releases emergency stores of glucose to give energy
�?digestion stops because it is not necessary for immediate survival
�?clotting ability of the blood is increased in case of injury.

This all means that you have been made ready to run faster, fight back and generally react more quickly than normal. Unfortunately, when your blood sugar level drops during the day or night, adrenaline is released automatically and the body experiences all the above sensations except that there is no outside stress to respond to. When this happens repeatedly, you can experience all the health problems outlined under the hypoglycaemia section earlier in this chapter. It can also contribute to heart disease by increasing the risk of blood clotting and higher blood pressure and the sudden release of glucose for energy can cause extreme fluctuations of sugar levels in the blood.

These fluctuations in blood sugar create an internal stress which the body then has to deal with. It causes an increase in sodium retention causing a bloated feeling from excess water. The digestive system will not function efficiently and less stomach acid will be produced which means that more food will actually be stored because it has not been digested sufficiently. The longer food stays in the intestines and remains undigested, the more calories are likely to be absorbed. It is therefore important that food is moved quickly out of the intestines.

Cravings and Binges �?What's the difference?

Cravings

Most dieters experience cravings to a lesser or greater degree. With some it is for chocolate, with others it is for biscuits and cakes. Certainly it is for sweet foods that most people crave although some dieters crave fats �?especially cream and hard cheese. Others, who don't usually have a drink problem, can find themselves craving a glass of alcohol. The sugar cravings are caused by the fluctuating blood sugar levels that we've just looked at. The other cravings could be caused by a food allergy or perhaps a yeast problem.

By and large you can control your own cravings, even those linked to the hormonal ups and downs of the menstrual cycle. It might be hard at first but by following the rules in this chapter you will find that with the passing of each successful day it will get easier and eventually the cravings will cease.

Binges

Binges can signal a more serious problem. Giving in to a craving and eating a bar of chocolate or several biscuits is not bingeing. A binge is eating for eating's sake, almost uncontrollably and even when you aren't hungry. Binge-ers have been known to grab at food with their hands rather than waste time with a knife and fork. There is a desperation about binge-ers who often binge in response to an emotional upset. Eating non-stop until you've finished a family-sized tub of ice cream, or a complete gateau, for example, is bingeing. So too is eating to the point of being sick. This is a long way from the normal cravings that most dieters experience.

Binge-ers will often feel physically and mentally ill after they've binged and it can be associated with psychological illnesses, like bulimia.
If you know that you binge, it is advisable to see your GP.

Eat plenty of unrefined complex carbohydrates including, wholewheat bread, wholemeal pasta, potatoes, brown rice, millet, oats, rye.

Eat fruit and drink diluted fruit juice.

Always eat breakfast �?porridge oats are good.

Eat small, frequent meals no more than three hours apart or five hours apart for men as their metabolism is slower.

Reduce, preferably avoid, stimulants including tea, coffee, chocolate, smoking and canned drinks that contain caffeine.

Consider taking one of the excellent food supplements on the market that can help balance your blood sugar while you are changing your eating patterns. See Table 1 above.

Develop the habit of reading labels carefully.

DON'T

Eat refined carbohydrates �?avoid 'white' in general. Remember that white flour is in many things like cakes, biscuits, pastries and white bread.

Eat sugar or the foods containing it �?including chocolate, sweets, biscuits, pastries, soft drinks.

Substitute decaffeinated coffee (as it contains two other stimulants, even when the caffeine is removed).

Eat convenience foods, they are likely to contain refined carbohydrates, sugar and high levels of fat and salt.

How can highs and lows be prevented?

There are three good ways:
1. Eat complex carbohydrates regularly
2. Avoid refined foods, especially sugar
3. Reduce foods and drinks that are stimulants

1. Eat complex carbohydrates regularly
To maintain well-balanced blood sugar levels eat foods such as complex carbohydrates that give a slow rise in blood sugar and keep a constant level for about three hours. Then eat again and prevent the level from dropping. Spacing food at three-hourly intervals in this way is a proven solution to the battle with cravings.

Dr Katharina Dalton, a pioneer in the recognition and treatment of pre-menstrual syndrome (PMS), has found that the symptoms of PMS can be relieved by eating regularly. This stops the blood sugar level from dropping and adrenaline from being released. While Dr. Dalton's findings have proved invaluable for PMS sufferers it serves to confirm the general theory that actually applies to all of us, including men.

Complex carbohydrates give a slow release of energy because it takes time for the digestive tract to break them down into simpler substances that the body can use. Carbohydrates are a large group of foods that includes sugars and starches. They are an important source of energy and the body breaks them down into the simple sugar, glucose. It is the slow speed with which this happens that is important to keeping blood sugar constant.

There are two types of carbohydrates:
Complex
�?Grains (wheat, rye, oats, rice, barley, maize)
�?Beans (lentils, kidney, chickpeas, aduki etc)
�?Vegetables, including potatoes
�?Fibre in grains, beans and vegetables

Simple
�?Fruit
�?Honey
�?White and brown sugar
�?Glucose in high-energy drinks

To help maintain a steady blood sugar level, aim to eat complex carbohydrates as part of your main meals and also as snacks during the day. You do not necessarily need to eat great amounts �?sometimes just an oat cake can be enough between meals to keep eating urges at bay.

If you find the symptoms associated with low blood sugar levels are greatest first thing in the morning or, you wake during the night, heart pounding and cannot get back to sleep, then it is very likely that your blood sugar level has dropped overnight and adrenaline has kicked into play. Eating a small, starchy snack, like an oat cake, one hour before going to bed and if possible, one hour after getting up, will help to alleviate these symptoms.

Make sure your complex carbohydrates are unrefined, which in general means choosing brown instead of white. For example, wholewheat bread, brown rice and wholemeal flour as opposed to the white versions which have been refined and therefore stripped of essential vitamins, minerals, trace elements and valuable fibre content. In order to digest these refined foods your body has to use its own vitamins and minerals, so depleting your own stores.

Fibre

It was originally thought that fibre's role was only to speed up the passage of food residues to prevent constipation. It is now known that some forms of fibre can actually slow down the absorption of sugars and help to maintain our blood sugar balance. Without fibre, food will affect the blood sugar level more quickly and it is harder to eliminate the food residues. The food stays in the body longer, which means that it absorbs more calories so preventing you from shedding those pounds.

Cravings and food allergies

If you experience cravings it's likely to be an indication that you suffer from blood sugar imbalance. They may also be symptoms of a food allergy, so this is worth checking. Ironically, if we are allergic to a particular food, we tend to crave it and eat it more. Ask yourself the question: "Which foods or drinks would I find it hard to give up?" The answer will give you a clue as to what to look out for

Shirley had been experiencing bad PMT symptoms and throughout the month would feel extremely hungry by about 5pm even though dinner was not until 6pm. We talked about her pattern of eating and she said that she was drinking up to eight mugs of tea a day. I explained the effects of drinks like tea and coffee on blood sugar balance and their link to PMT symptoms and advised her to gradually wean herself off drinks containing caffeine. Unfortunately, Shirley decided to cut out the eight mugs of tea straight away and rang me a couple of days later complaining of a bad headache and flu-like symptoms. Cutting caffeine out of your regime really must be done over a few days and it is best to begin by having half your drinks caffeinated and half de-caffeinated. Then over the next few days reduce the amount of caffeinated cups even further. Eventually you should cut out the de-caffeinated coffee because it still contains stimulants despite the absence of caffeine. Gradually introduce herb, fruit or grain tea so that you are still drinking the same amount of liquid. Once Shirley had taken the advised course of action it took her just a few days to feel a lot better. By the time I saw her two cycles later she was eating little and often and this pattern of eating had really helped with the PMT symptoms.

2. Avoid refined foods, especially sugar

The simple carbohydrates (with the exception of fruit) are all refined foods and should be avoided. Although fruit contains fructose (fruit sugar) which is a simple sugar, the fibre content of the fruit is a complex carbohydrate which slows the digestion rate. So fructose is acceptable when taken in the whole fruit, like an apple, but not when used in the refined form of powered white fructose, which is bought in boxes.

Pure fruit juice can also cause a rapid change in blood sugar levels because it is not buffered by the fibre that is normally present. It is better to dilute fruit juice in water to make it less concentrated.

Sugar sneaks unexpectedly into many foods. By the way, the brown-is-best theory doesn't apply to sugar, all colours do the same damage to your blood sugar balance! A can of cola may contain up to eight teaspoons of sugar as may a pot of fruit yogurt. Most of the convenience foods and drinks we buy are laden with sugar including savoury foods such as baked beans and mayonnaise. Did you know that tomato ketchup has just 8% less sugar, weight for weight, than ice cream and that the cream substitute for coffee is 65% sugar compared to 51% for a chocolate bar?

Sugar is an inexpensive bulking agent. Even some toothpastes contain sugar but as toothpaste is not a food, sugar does have to be included on the ingredients list.

When sugar is in its natural form �?the whole sugar cane �?it is fine to eat. It has all the right amounts of fibre and is a wholefood. When it is refined sugar is just 'empty' calories �?it contains no nutritional value so you can stop eating it and lose nothing but weight.

You may be tempted to substitute sugar with artificial sweetners �?DON'T! You are simply introducing an alien chemical which the body then has to deal with. Nobody really knows what havoc these chemicals can cause when introduced to the body's own delicately balanced biochemistry.

If a food or drink is described as 'low sugar' or 'diet' it will usually contain a chemical sweetner. These are also found in some non-diet crisps, ice lollies, sauces, pot noodles and some over-the-counter medicines. It's worth checking labels carefully.

3. Reduce foods and drinks that are stimulants

Sugar, smoking, caffeine in tea, coffee, chocolate and caffeinated soft drinks are all stimulants and cause a fast rise in blood sugar level followed by a quick drop which contributes to the roller-coaster ride of blood sugar swings. Avoid them whenever possible, even better, cut them out of your diet completely. Substitute them for example with herbal teas, grain coffee, spring water and diluted fruit juices.

"Minimizing the Most Common

Side Effects to Quitting Smoking"

Blood sugar plummets in many people when first quitting. The most common side effects felt during the first three days can often be traced back to blood sugar issues. Symptoms such as headache, inability to concentrate, dizziness, time perception distortions, and the ubiquitous sweet tooth encountered by many, are often associated with this blood sugar drop. The symptoms of low blood sugar are basically the same symptoms as not having enough oxygen, similar to reactions experienced at high altitudes. The reason being the inadequate supply of sugar and/or oxygen means the brain is getting an incomplete fuel. If you have plenty of one and not enough of the other, your brain can not function at any form of optimal level. When you quit smoking, oxygen levels are often better than they have been in years, but with a limited supply of sugar it can't properly fuel your brain.

It is not that cigarettes put sugar into your blood stream; it is more of a drug interaction of the stimulant effect of nicotine that affects the blood sugar levels. Cigarettes cause the body to release its own stores of sugar and fat by a drug type of interaction. That is how it basically operated as an appetite suppressant, affecting the satiety centers of your hypothalamus. As far as for the sugar levels, nicotine in fact works much more efficiently than food. If you use food to elevate blood sugar levels, it literally takes up to 20 minutes from the time you chew and swallow the food before it is released to the blood, and thus the brain, for its desired effect of fueling your brain. Cigarettes, by working through a drug interaction causes the body to release it's own stores of sugar, but not in 20 minutes but usually in a matter of seconds. In a sense, your body has not had to release sugar on its own in years, you have done it by using nicotine's drug effect !

This is where many people really gorge themselves on food upon cessation. They start to experience a drop in blood sugar and instinctively reach for something sweet. Upon finishing the food, they still feel symptomatic. Of course they do, it takes them a minute or two to eat, but the blood sugar isn't boosted for another 18 minutes. Since they are not feeling immediately better, they eat a little more. They continue to consume more and more food, minute after minute until they finally they start to feel better. Again if they are waiting for the blood sugar to go up we are talking about 20 minutes after the first swallow. People can eat a lot of food in 20 minutes. But they begin to believe that this was the amount needed before feeling better. This can be repeated numerous times throughout the day thus causing a lot of calories being consumed and causing weight gain to become a real risk.

When you abruptly quit smoking, the body is in kind of a state of loss, not knowing how to work normally since it has not worked normally in such a long time. Usually by the third day, though, your body will readjust and release sugar as it is needed. Without eating any more your body will just figure out how to regulate blood sugar more efficiently.

You may find though that you do have to change dietary patterns to one that is more normal for you. Normal is not what it was as a smoker, but more what it was before you took up smoking with aging thrown in. Some people go until evening without eating while they are smokers. If they try the same routine as ex-smokers they will suffer side effects of low blood sugar. It is not that there is something wrong with them now, they were abnormal before for all practical purposes. This doesn't mean they should eat more food, but it may mean they need to redistribute the food eaten to a more spread out pattern so they are getting blood sugar doses throughout the day as nature really had always intended.

To minimize some of the real low blood sugar effects of the first few days it really can help to keep drinking juice throughout the day. After the fourth day though, this should no longer be necessary as your body should be able to release sugar stores if your diet is normalized. If you are having problems that are indicative of blood sugar issues beyond day three, it wouldn't hurt talking to your doctor and maybe getting some nutritional counseling. In order to allow your body to maintain permanent control over the amount of glucose (sugar) in your brain ... NEVER TAKE ANOTHER PUFF!

Joel

From: Joel

Sent: 7/18/2005 3:23 PM

If you are having problems that are indicative of blood sugar issues beyond day three, it wouldn't hurt talking to your doctor and maybe getting some nutritional counseling.

Actually very few people experience this specific issue, but even so, that fact does very little good if you are indeed one of these people. It is important that everyone listens to his or her body after he or she quits smoking. In fact, if people listened to their bodies throughout their lives nobody would ever take up smoking.

The first puff taken in childhood most likely told the person that smoking was not a good choice, considering most people hack and cough and experience pain with the first puff. Unfortunately, they also experience a drug fix and often, at the same time they have others around encouraging them to stick with it even in the face of such pain.

Listen to your body now though. If something isn't feeling right, just don't assume it is a normal effect from not smoking. Get symptoms checked out if symptoms or problems persist. While you may not have listened to your body while you were actually still smoking, it was still likely sending you messages. Think back upon what those messages were. The more you remember what your body was telling you while you were smoking the more resolute you will stay now to stick with your commitment to never take another puff!

Joel

Also see strings:

Life goes on without smoking

Medication adjustments

Giving and getting medical advice online

Colleen, Joel has covered every issue raised by your question but without scaring you too much we need to add that if you continue to use nicotine it isn't a matter of if you are going to harm your unborn child but how badly. The way that nicotine works in your mind is that it activates millions of nicotinic acetylcholine receptors unleashing a host of neurochemicals throughout your mind and body. Not only does it release dopamine, the "aaahhh" feeling you experience within 8 to 10 seconds of a puff but it activities your body’s fight or flight pathways releasing adrenaline, chemicals to make your heart beat faster, it perks your senses, shuts down digestion, and constricts all peripheral blood vessels.

In your unborn baby’s developing mind the acetylcholine receptors actually develop prior to the neurons (brain cells) that they should eventually be connected to. In other words the communication and chemical pathways are not yet complete when nicotine begins docking at receptor sites and attempting to activate still developing brain cells. The result is a nightmare and a brain that does not get wired propertly.

Colleen, yesterday I traded e-mails with two of the leading fetal nicotine researchers. I’d like to share a portion of comments. The first is from Dr. Theodore Slotkin, Ph.D., Professor, Dept. of Pharmacology & Cancer Biology at Duke University Medical Center. Dr. Slotkin wrote:

"This issue isn’t mutagenesis or genotoxicity, but rather effects on brain development and nervous system function (major contributors to perinatal morbidity/mortality, SIDS and subsequent cognitive and behavioral disorders). There is no question that nicotine, in the levels commensurate with plasma levels in smokers or NRT patch users, has an adverse effect on brain development (hundreds of animal studies published, not just mine)."

The second response is from Dr. Andrea Allan with the Department of Neurosciences at the University of New Mexico:

"I completely agree with Dr. Slotkin's assessment. Some of the damage to the developing nervous system will not be visible until later on in life. We are now seeing epigenetic changes in the neural tissue taken from mice exposed prenatally to very moderate levels of nicotine."

Dr. Allan had a new study published in March. Let me share the opening line from the study’s summary: Prenatal nicotine exposure (PNE) has been associated with increased prevalence of attention deficit hyperactivity disorder (ADHD), major depressive disorder (MDD) and substance abuse in exposed children and adolescents.

Colleen, if I were in your shoes I’d immediately begin reading Joel’s free quit smoking book one time from cover to cover. It is a wonderful collection of about 100 short quitting articles that will provide you with a wonderful quitting foundation. You can read an online version at http://whyquit.com/joel/ or download a PDF version at http://whyquit.com/joel/ntap.pdf

Let this be your loving gift of "you" to you, Colleen. Your baby can either bond to the more than 3,500 chemical particles and 500 gases released by each burning cigarette, as they coat a new mother's hands, face, hair and clothing, or bond to the natural smell beneath. The choice is yours!

Quit for one hour and then celebrate! Not only did you spend the hour healing, the fetal brain nicotine concentrations of the unborn life developing inside will have declined by one-fourth. There is just one rule, Colleen. No nicotine just one hour, challenge and day at a time!

Breathe deep, hug hard, live long

John (quit nicotine - May 15, 1999)

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