Serotonin, Mood and Weight Loss — An Interview with Judith Wurtman

We all want to feel the best we can right? We want to be happy dammit!

Well, it turns out that feeling good has a whole lot to do with chemicals–brain chemicals called neurotransmitters and one of those is called serotonin.

Dr. Judith Wurtman is an expert in serotonin. She lives in Boston, Massachusetts and has researched serotonin for many years at MIT. She’s kindly agreed to help us out with some questions about this whole idea of how serotonin is connected to feeling good but also, surprisingly, to obesity, emotional eating, and binge eating.

Judith’s authored over 40 peer reviewed studies on the subject as well as several books including The Serotonin Power Diet. which was co-authored with her friend and colleague Dr. Nina Marquis.

I’ve been fascinated to read about Judith and Nina’s work and ideas, so I want to make sense of serotonin in light of what’s known about the natural and evolutionary picture for us humans.

Mike: Hi Judith, welcome and thanks for helping us out.

Judith: Hi, I am delighted to talk about serotonin, eating and mood.

Mike: I know you’re especially interested in the connection of obesity and weight gain to anti-depressants. What’s the connection there?

Judith: Weight gain is a major side effect of antidepressant use; people often gain between 15-35 pounds. And some of the related medications used by bipolar disorder can cause more than a 100 lb weight gain. People who are gaining weight report feeling unsatisfied after eating a meal.

They want to continue to eat even if their stomachs are full. And they experience a persistent craving for sweet and starchy foods. We think that the antidepressants are blocking serotonin’s ability to turn off the appetite.

Mike: Both you and Nina run weight management centers, is that right? Do you have a good success rate with your system?

Judith: Our patients who have gained weight from emotional overeating, antidepressants use or both have done very well on our program. They tend to lose about 20 lbs in about 10-12 weeks and they keep it off. They also tell us that they sleep better and their mood improves.

Mike: Can you tell us a bit about how introducing the carbohydrate only meal and snack have an effect on the mood of the people you treat. Do they literally go frombeing depressed to being happy and if so, how long does it take?

Judith: My husband who is a professor at MIT discovered that the brain makes serotonin after carbohydrates are eaten because after sweet and starchy foods are eaten, insulin is released. Insulin changes the composition of the blood so that an amino acid (a building block of protein) called tryptophan can cross through a barrier surrounding the brain.

Serotonin is made from tryptophan. When it is made, appetite is subdued and the mood gets better. This happens within 20-30′ after eating a specific amount of carbohydrate. So a carb snack like a whole grain roll or a meal of carbohydrate like rice or potatoes and vegetables will increase serotonin promptly.

And if the eater is grumpy or tired or distracted, these feelings go away and are replaced by a better mood. But a potato will not make a clinical depression go away. Carbs affect only normal fluctuations in mood.

Mike: You say that without starch or sugar eaten alone (with only minimal or no fat and no protein), our brain can’t make serotonin. So what happens in people who eat all mixed meals—why aren’t they all depressed?

Judith: Most people eat carb by itself once a day as a snack or usually for breakfast. People who avoid carbs, or always eat them mixed with protein, may indeed suffer from minor changes in mood without even realizing it. Women have less serotonin than men so they are more vulnerable to the absence of carbs in their diet. But the Atkins attitude; i.e. bad mood after eating protein was well known in the U.S a few years ago.

Mike: Is the minimal or no fat rule just about excess calories or is there a biological reason?

Judith: Since we are writing for, and advising dieters, we want to avoid excess calorie intake. However fat slows down digestion. And when you want your mood to improve, right now, don’t eat something that takes ages to digest.

Mike: You say that sugar (sucrose), which breaks down into glucose and fructose produces serotonin, but not fruit—which is already is a combination of glucose and fructose. Can you explain why that is?

Judith: It is the glucose that triggers insulin; fructose has to travel to the liver to be converted to glucose. We developed a carbohydrate drink called ‘Serotrim’ that uses glucose, not sucrose along with other longer chain carbohydrates to induce serotonin synthesis.

Mike: OK, so why doesn’t the glucose in fruit do the job? We know fruit raises insulin too, no?

Judith: No, fruit does not raise insulin and most of the sugar in fruit is fructose. Grapes have more glucose but there is not enough to stimulate insulin release. We

know all this from blood tests which are done before and after different sugars are consumed. We look for a change in the patterns of amino acids in the blood caused by insulin release. Glucose is great; fructose gets a D-.

Mike: Some fruits contain a lot of glucose… bananas and grapes as you mentioned have around a 1:1 glucose to fructose ratio. Fruits are also listed in the Glycemic Index and the Insulin Index so they must affect blood sugar and insulin. Both these fruits have high scores on both indices.

The starch thing is also difficult for me to understand from an evolutionary standpoint. I wonder how our ancestors’ brains could have made serotonin and how modern day chimps who share around 98% of related genes to humans make serotonin.

Judith: I think we have a lot of research to do on subhuman primates and also what early hominids ate. Do chimps get depressed?

Mike: Only if you steal their bananas :-) When I did a completely raw diet of only fruits, salads and nuts/seeds for 6 months to overcome Chronic Fatigue Syndrome, I became very happy. The raw diet, at least short term, is well known to create a feeling of happiness and well being. Do you know why this might be in terms of serotonin when there’s minimal starch and no sucrose?

Judith: No idea. But your gender may have something to do with it. Women need to replenish serotonin more than men and indeed people have used carbs to increase serotonin because this neurotransmitter also decreases pain perception.

Mike: Well the women feel very happy too :-)

Judith: Are you still on the diet?

Mike: I don’t do all raw now no. I’m doing the Habit Guide Diet which isn’t so extreme but still I eat a lot of raw fruit, veg, nuts and seeds. I feel we need more independent solid science on raw diets to find out why some people don’t do well long term. But it’s the future for sure I feel.

Amazing healings are happening when people do this diet properly, but the long term picture is hazy. Like I say, I think we need more data, and I’m sure that will come in time. Our pre-agriculture diet (paleo) is also very interesting and enlightening but is the other extreme as far as animal foods goes. The truth of what is optimal probably lies somewhere in-between.

We could really do with some clever science people looking into all this stuff! Can you get the word out? :-)

Judith: Mike, it would be interesting to compare people’s responses on the raw diet during different seasons. I suspect people do better on it during the spring and summer but once the days begin to shorten, they need to eat more carbs. That is another story but it would be interesting to check it out.

Mike: Yes, that would be… there’s a whole list of questions I’d love to get answers to. :-) This is 2007 and we’re still arguing about what’s best for humans to eat.

Considering the massive power that nutrition has for good or bad outcomes, that seems totally crazy to me. I’d like to lock all the nutritionists, scientists and health gurus in a big room with lots of types of food, a blackboard and some test tubes and not let them out until they all agree!! :-)

Judith: Don’t forget that for most of our life on this planet, we were struggling to get enough food to eat; we had very limited choices, especially if we lived in cold climates and most people were probably dead by 35. The real problem is that people give out information and advice based on nothing more than anecdotal evidence.

It is hard to do nutritional research, especially when it involves behavior and the studies are tedious and expensive. Common sense and listening to one’s body goes a long way when deciding how and what to eat.

Mike: Isn’t common sense anecdotal? :-)

If I hadn’t listened to other experiences and ideas, and thought things through myself, my 13 years of hell with Chronic Fatigue Syndrome would never have ended.

Science is incomplete or why are we still studying? There’s no overall framework within nutritional science that is looking at “What is a natural diet for humans.” The results of individual studies aren’t being looked at in terms of how they fit into the big picture, in my view. This is a whole other subject… maybe we shouldn’t get into this right now :-)

Mike: Do you feel that the serotonin situation adds a great weight to the argument that the best diet would have complete separation of carbs and proteins at all meals and snacks?

Judith: No. Carbohydrates should be eaten separately only when the eater wants the satiety effects of serotonin and the good mood effects. Otherwise people should eat for the nutritional value of food and pay attention to the variety of foods they are eating so they eat a healthy diet rather than the order in which they eat them.

Mike: Oh right, so this isn’t something that everyone should do—the afternoon carb snack and carb only dinner?

Judith: Not everyone experiences a change in mood late in the afternoon and not everyone is snacking after dinner. The diet is for the 99% of people who have craving around 4 in the afternoon associated with a decline in emotional well-being ( the decline can be very slight) and people who find they have to eat after dinner to relax enough to go to sleep.

A carb dinner helps them calm down and turn off the problems of the day. But if as they say here, it isn’t broken, don’t fix it. If you don’t have these mood changes and cravings, you don’t have to snack on carbs or eat a carb dinner.

Mike: I’ve often read the advice of a having a late evening protein snack to raise the blood levels of the amino acid tryptophan (which is needed to make serotonin). Is this good advice?

Judith: Protein contains tryptophan but as my husband discovered, the other amino acids which are always present in much larger amounts than tryptophan, compete with tryptophan for entry into the brain.

So eating protein prevents tryptophan from getting into the brain. And no serotonin is made. The only way tryptophan gets into the brain is for insulin to remove the competing amino acids from the blood and let tryptophan which is always there, to get into the brain. We cover this in great detail in our book.

Mike: OK, so the ratio of tryptophan to the other aminos is the critical thing and that is only favorable for serotonin when insulin removes the other aminos but not tryptophan. Is that about right?

Judith: Perfect

Mike: How much carbohydrate is needed in the late afternoon snack you recommend?

Judith: We recommend about 30 grams or so, around 140-145 calories. And the food should be low in fat of course and also low in protein.

Mike: The addictive opioids in the gluten of some grains are often thought to be the cause of bingeing on grain based carbohydrates. How does this tie in with serotonin? Does eating say potato or sweet potato cure the problem and therefore mean that the opioids are not a factor or could it be a combination?

Judith: I am not familiar with research that have isolated opioids from grains and shown that they cause bingeing behavior. Grains are obviously high in starch so their ingestion will promote serotonin synthesis. But serotonin then turns off appetite.

Often bingeing occurs when people do not wait the 20 or 30 minutes for the food to be digested but keep on eating until they feel an effect. It is like taking aspirin continuously until the headache goes away.

Mike: Bananas are often touted as being great for serotonin levels because of natural tryptophan and B6. Is this true?

Judith: No.

Mike: So the old “banana at bedtime” is also a myth eh? What’s your recommended supper for happiness and a good night’s sleep?

Judith: Pasta, potatoes, rice, oatmeal, if you were northern Italian, polenta or just a bowl of soup and crusty bread and a salad.

Mike: OK on that note, I think we’ll put our chat to bed :-) (Groan). It’s been really fascinating, and for me, perhaps adds weight to the idea that mixing foods is not a good idea, especially when you add in other arguments and also consider that mixing foods is never seen in nature.

Judith: I really don’t think it is necessary to separate foods; 3000 years ago or longer people were eating mixed meals. And when I see what my dog wants to put in his mouth after sniffing the picnic leftovers in a local park, I am glad I am not eating ‘in nature’.

Mike: OK shall we leave it there? Thanks so much for helping us out Judith.

Judith: Thank you for all your hard work.

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Habit Guide: How to be Happy & Healthy