Introducing the concept of nutrition into a treatment program is not an easy task. Many addicts in early recovery are not ready for health behavioral change, since most are simply trying to get past the immediate crisis of addiction and the associated life adjustments of abstinence. In fact, sobriety can magnify pre-existing dysfunctional eating behavior. Many addicts began using drugs and alcohol in their early teens and never developed a healthy relationship to food.
Many people in early recovery crave sweets and simple carbohydrates such as candy, juice, cereal, grilled cheese, peanut butter and jelly, or ice cream. In addition to such food preferences, many may have damaged their digestive system through the use of alcohol, pills, opiates, and other substances.
Additionally, the reward deficiency syndrome created by chronic exposure to addictive substances often requires that the food consumed be highly rewarding to the brain. These foods are typically sweet, salty, high fat, easy to digest, or some combination of these traits. Examples include chips, cookies, and most processed snack foods.
While excessive weight gain is certainly an issue and can lead clients back to using substances, the bigger problem is malnourishment, which limits the ability of the brain to heal from the ravages of addiction. Low quality food leads to low quality thinking, and can lead back to using drugs and alcohol.
What we crave
There are many factors that contribute to how a person eats — food availability, financial resources, and general food philosophy. But to generalize about the average addict in sober living, it might look something like this:
Breakfast consists of several cups of coffee with flavored creamer and sweeteners, cigarettes or “vape,” and perhaps an energy drink. If food is consumed it’s typically bacon, eggs, hash browns, and/or sugary cereal
Lunch might consist of a white flour sandwich, burger, wrap, or pizza, all of which lack fruits and vegetables. Often lunch is from a fast-food restaurant.
Snacks throughout the day include candy, chips, cereal bars, soda, energy drinks, and sweetened coffee.
Dinner typically is protein and starch such as pasta and meatballs or meat pizza. Vegetables may or may not be present.
Between 10pm and 1am is when the real eating occurs. Many people are on medications such as Seroquel that can lead to loss of control and increased food consumption. Typical nighttime snacks include sugary cereal, ice cream, bread, bagels, tortillas with melted cheese, pizza, and other highly processed foods that can lead to a full blown binge episode.
It’s simple: Eat real food.
If someone in early recovery is offered a choice between addictive food and nutritious food, most will select the more “rewarding” choice. The problem is that this “reward” generated by the brain gives the patient the illusion that they are getting what they need, when in reality they are just stimulating dopaminergic neural pathways. What they really need is a diet high in protein, fiber, omega-3 fatty acids, antioxidants, and vitamins and minerals. Think of the six food groups: fruits, vegetables, grain, dairy, animal protein, and plant protein such as beans, nuts, and seeds. The goal is to get representation from all six food groups at least twice a day and to avoid items that cannot be classified into this food group system.
Sample Meal Plan
Breakfast could consist of a fruit smoothie with mixed frozen berries, banana, spinach, unsweetened Greek yogurt, flax seeds, unsweetened almond milk.
Healthy morning snacks include a piece of cinnamon raisin sprouted whole grain bread with almond butter, and hardboiled eggs.
Lunch consists of a large plate of mixed raw veggies topped with tuna or chicken salad, or a lentil, bean, or grain soup. Snacks include fruits, string cheese, and a handful of nuts.
Dinner could be quinoa or other whole grain such as farro, salmon, asparagus, and a green salad topped with pine nuts. For a snack have a bowl of frozen cherries topped with unsweetened Kefir and cocao nibs.
Why Not Just Take a Multivitamin and Eat for Pleasure?
It’s a common mistake to assume that the daily consumption of a multivitamin will “cover all of the nutritional bases.” Of course, supplemental nutritional can be helpful if the person has a compromised ability to eat or has a limited diet. But too often, people fall into the trap of using multivitamins to assume they do not have to concern themselves with the nutritional quality of their food. For starters, supplemental vitamins will never be able to contain the antioxidant potency of real food. Phytochemicals that flourish in real food cannot always remain stable in a supplemental form. Second, arguably the most important nutrient for addiction recovery is fiber, which is found in fruits, vegetables, whole grains, beans, nuts, and seeds. It is of paramount importance to eat fiber from food – not fiber supplements – to improve gut function and achieve balance in the microorganisms that live throughout the gastointestinal tract. Lastly, consumption of highly processed junk food throughout the day can significantly hinder the recovery process in numerous ways:
• Unstable blood sugar impacts mood and concentration
• Nutrient-void food can leave patients feeling sluggish and reliant upon caffeine (for the illusion of energy)
• Refined grains, added sugars, and added fats will negatively alter the microbiome (which we are discovering has an impact on mental health)
• Highly palatable food will condition the brain to expect food to taste a certain way, perpetuating the cycle of food addiction and promoting substance-seeking behavior. For example:
• Eating candy will make eating fruit become less appealing.
• Sweetened beverages will make drinking water less appealing.
• Heavily seasoned and sauced food will make plain food be less appealing.
What can you do?
Consider this a call to action to implement healthy eating for sobriety. Consult with a registered dietitian nutritionist, particularly ones that have training and expertise in the addiction population. Consider embracing the following:
• No sweetened beverages (sodas, sports drinks, etc.) including “diet” drinks
• No candy (or highly sweetened foods)
• No fried foods (i.e. chips)
• No refined grains (use whole grains)
• Cereals should have more grams of fiber than grams of sugar
• Dessert should only be served as dessert
The primary focus should not be about what not to eat, and should always be about what to eat.
David Wiss MS RDN is the founder of Nutrition In Recovery and a co-founder of Dietitians for Professional Integrity. www. NutritionInRecovery.com.