Is pain fueling your sugar cravings?

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Chronic pain does all sorts of weird and not so wonderful things to our bodies. When we start looking at our bodies as a whole system, things start to make a little more sense as to why something that may not be obviously linked, starts to present issues.

We know that chronic pain triggers the release of several stress hormones because our fight and flight response is in hyperdrive. In ‘fight or flight mode’, several physiological changes occur, including an increase in the production and release of stress hormones like cortisol and adrenaline.

Our brains are essentially telling our bodies we need to go-go-go. These hormones also signal a need for rapid release fuel. Our brain says to the body “I need quick energy to run from the dinosaur”. Typically this is glucose because it is a rapidly available energy source for our bodies, particularly in ‘fight and flight mode’.

Pain fuels sugar cravings. Sugar fuels pain. It’s a vicious cycle.

Breaking the cycle

So stress hormones can increase the body’s demand for glucose. BUT our bodies don’t actually need sugar as a fuel to run effectively. Understanding what optimally fuels our bodies can help us regain control over our pain.

While mainstream pain medicine has a long way to go in this space, there is more research demonstrating that a high protein, high fats and low carbohydrate eating has a positive impact on reducing pain and reducing systemic inflammation.

Our bodies are supremely intelligent (even if they are glitching with pain signals).

In the absence of carbohydrates (which breaks down into glucose) our bodies kick off a process called gluconeogenesis. This is where our bodies synthesises glucose from non-carbohydrates: amino acids (from protein) and glycerol (from triglycerides in fat).

Our bodies can also kick off a process called lipolysis. This is when the body the body shifts to using fat stores for energy. Next, beta-oxidation can happen in the mitochondria to make acetyl-CoA. This then goes into the Krebs cycle (citric acid cycle) to make ATP, which is the body’s main energy source.

Then there’s ketosis. This is where our bodies shift from running on glucose to running on ketones. The liver can convert excess acetyl-CoA derived from fatty acids into ketone bodies, such as acetoacetate, beta-hydroxybutyrate, and acetone, through a process called ketogenesis. Ketone bodies then serve as an alternative fuel.

I feel my best when I am in ketosis. My energy is better, my pain is dramatically reduced, my allodynia is quieter, I don’t tend to have the radical flares from weather changes. I just feel better.

How sugar fuels pain

Simply, sugar fuels inflammation. Inflammation is what sits as a trigger for pain flares.

When we are able to more effectively limit inflammation that we tend to add to our bodies through what we eat, we can start to reduce the inflammation which has a flow on effect to our pain levels.

Let me get a lil nerdy for a minute and run through how sugar causes inflammation…

Insulin resistance

Insulin resistance isn’t something that just concerns diabetics. The amount of hidden nasties in our foods is making this a much greater concern for the wider population. We are not meant to eat the amount of sugar that is being hidden in our food.

Eating a lot of sugar, especially refined carbs and high-fructose corn syrup, can contribute to insulin resistance. Insulin resistance happens when cells stop responding as well to insulin, which makes blood sugar levels rise. Having long-term insulin resistance is linked to making more cytokines and C-reactive protein (CRP), which are chemicals that cause inflammation throughout the body.

Production of advanced glycation end products (AGEs)

When sugar molecules bind to proteins or fats in the bloodstream without enzymatic control (i.e. insulin), they can form advanced glycation end products (AGEs).

By turning on receptors on defence cells and encouraging oxidative stress, these AGEs can cause inflammation. AGEs are also linked to the development of long-term diseases like diabetes, heart disease, and neurodegenerative illnesses, all of which are characterised by inflammation.

Activation of the NLRP3 inflammasome

A group of proteins called the NLRP3 inflammasome have a central role in starting the inflammatory reaction. It has been shown that eating a lot of sugar, especially fructose, turns on the NLRP3 inflammasome. This causes pro-inflammatory cytokines like IL-1β and IL-18 to be released. This activation contributes to the development of inflammation and related metabolic disorders.

Dysregulation of gut microbiota

Eating too much sugar can change the types and amounts of microbiota in the gut, which can cause dysbiosis (an imbalance in gut bacteria). More intestine permeability, or “leaky gut,” is linked to dysbiosis. This lets bacterial toxins enter the bloodstream and cause inflammation. Dysbiosis can cause chronic inflammation, which can make metabolic conditions like obesity and insulin resistance more likely to happen.

There are also studies that are showing that synthetic sweeteners can have similar negative impacts on the gut. Personally, I think we should be treating anything made with a sweetener in the same way we would any other treat. It’s a treat.

While keto sweeteners are generally better for you in terms of managing blood sugar, there’s a lot still unknown.

Elevated uric acid levels

Eating a lot of sugar, especially fructose, triggers your liver to make more uric acid. Uric acid levels that are too high have been linked to inflammation and the development of diseases like gout and metabolic syndrome.

Reducing sugar intake and opting for whole, unprocessed foods can help mitigate inflammation and reduce the risk of chronic inflammatory diseases.

The chicken or the egg

That is the million dollar question. But pain starts to cause it’s own feedback loop with this: pain fuels sugar cravings. Sugar fuels pain. It’s a vicious cycle.

When we’re not eating enough, or enough of the right things, pain becomes the tail wagging the dog.

I absolutely believe that eating is essential to maintaining good health. I also know that that is easier said than done some days. On days I can’t eat or not overly hungry from pain, I have some bone broth or a protein shake at least. I have protein snacks like little meatballs or protein muffins. Our bodies absorb protein better from whole food sources, but in the absence of that, things like bone broth are a good enough hack. It is better than having nothing which I know so many of us do.

Where to start

Eliminating sugar is a very conscious decision. Sugar and highly processed derivatives are in so many pre-made and processed foods that it is an intentional exercise to avoid it and make different choices.

Having the spoons to make changes when you’re already feeling rung out, is hard. It’s not impossible.

Just start

Making gradual tweaks to your diet is going to be more sustainable.

Maybe for you that looks like

  • swapping to a low carb bread and pastas.
  • incorporating bone broth daily to increase your collagen and fats.
  • making an effort to eat breakfast even if it’s a smoothie.
  • swapping to a higher protein, low sugar yoghurt.
  • swapping the sugar in your tea for monkfruit.
  • swapping wheat crackers for brown rice crackers (low carb, not keto).

Eating enough of the right things can be challenge enough for a well person. Let alone someone who lives with chronic pain.

Be kind with yourself. If starting small is what works, you’ve started in the right direction. The point is that you’ve started.

Meal planning and prep

These two things help me stay on track. I can guarantee you that the weeks I don’t prep, I skip more meals and/or end up ordering Uber Eats.

We have a growing range of spoonie friendly meal plans which calculate out your macros, generate your shopping lists and give you all the recipes for the week. You can also dive into the recipe library for inspiration.

And meal prep doesn’t have to be a day long production. Most weeks, it looks like me marinating meat in dump bags, pre-chopping my veg and herbs, boiling some eggs and pre-cooking things like meatballs or wings or snags which I snack on or have for breaky.

Build a freezer stash

We have a whole selection of recipes which are prefect for bulk cooking and popping in the freezer.

This saves us countless spoons. Particularly on days we don’t feel like cooking, life has taken over or I’m having a bad pain day.

It honestly takes no more effort to cook a double recipe and freeze than it does to cook a single batch. I have a stash of takeaway containers and zip lock bags to portion freezer meals in.

Do not let perfection be the enemy of progress.

Sugar is a sneaky ba$tard and is hidden in so many things. Short of making everything yourself, it will trip you up at some point.

I still buy things that contain sugar or insulin spiking sweeteners. Sometimes it’s purely by accident because a brand has changed their ingredients or I wasn’t paying attention. Other times I consciously buy things like Beerenberg Tomato Sauce which has sugar in it. I have Mingle Tomato Sauce as well but some days I prefer the taste of the Beerenberg (and it’s still relatively low carb).

5 ingredient rule

When shopping, if something has more than 5 ingredients listed on the nutrition label, it generally belongs back on the shelf and not in your trolley. While not all ingredient numbers are bad, most of them are not fabulous for spoonies and tend to trigger flares. While I tend to know what the good ones are and are not, pain brain can take over and I’ve been known to buy things with the not so good numbers in them… #spoonielife

To keep myself sane, if I haven’t bought it before, or it has numbers, I put it back. It’s just not worth the spoons.

We try to include brand recommendations in our recipes to help reduce the spoons needed on detective work. When I started keto, many of the online stores stocked pretty clean products. With the change in economy and I’m guessing customer preferences, I’m noticing that the pre-made foods are not as clean as they once were. It pays to check the labels.


What have been your tricks for cutting sugar? Let me know in the comments 🙂


Disclaimer: No Spoons to Cook is based on our own experience and research, and what we know works best for us. It is not medical advice. Our recipes focus on low inflammatory ingredients, whole foods and are founded in ketogenic and low carb ways of eating. We encourage spoonies to stay curious, ask questions, do your own research, listen to your body and to work with a Registered Dietitian or Medical Professional when appropriate to tailor your nutritional needs to support your care plan and goals.

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