Many of us try to eat more fruits and vegetables and less ultra-processed food. But why is sticking to your goals so hard?

High-fat, sugar-rich and salty foods are simply so enjoyable to eat. And it’s not just you – we’ve evolved that way. These foods activate the brain’s reward system because in the past they were rare.

Now, they’re all around us. In wealthy modern societies we are bombarded by advertising which intentionally reminds us about the sight, smell and taste of calorie-dense foods. And in response to these powerful cues, our brains respond just as they’re designed to, triggering an intense urge to eat them.

Here’s how food cravings work and what you can do if you find yourself hunting for sweet or salty foods.

What causes cravings?

A food craving is an intense desire or urge to eat something, often focused on a particular food.

We are programmed to learn how good a food tastes and smells and where we can find it again, especially if it’s high in fat, sugar or salt.

Something that reminds us of enjoying a certain food, such as an eye-catching ad or delicious smell, can cause us to crave it.

The cue triggers a physical response, increasing saliva production and gastric activity. These responses are relatively automatic and difficult to control.

What else influences our choices?

While the effect of cues on our physical response is relatively automatic, what we do next is influenced by complex factors.
Whether or not you eat the food might depend on things like cost, whether it’s easily available, and if eating it would align with your health goals.

But it’s usually hard to keep healthy eating in mind. This is because we tend to prioritise a more immediate reward, like the pleasure of eating, over one that’s delayed or abstract – including health goals that will make us feel good in the long term.

Stress can also make us eat more. When hungry, we choose larger portions, underestimate calories and find eating more rewarding.

Looking for something salty or sweet

So what if a cue prompts us to look for a certain food, but it’s not available?

Previous research suggested you would then look for anything that makes you feel good. So if you saw someone eating a doughnut but there were none around, you might eat chips or even drink alcohol.

But our new research has confirmed something you probably knew: it’s more specific than that.

If an ad for chips makes you look for food, it’s likely a slice of cake won’t cut it – you’ll be looking for something salty. Cues in our environment don’t just make us crave food generally, they prompt us to look for certain food “categories”, such as salty, sweet or creamy.

Food cues and mindless eating

Your eating history and genetics can also make it harder to suppress food cravings. But don’t beat yourself up – relying on willpower alone is hard for almost everyone.

Food cues are so powerful they can prompt us to seek out a certain food, even if we’re not overcome by a particularly strong urge to eat it. The effect is more intense if the food is easily available.

This helps explain why we can eat an entire large bag of chips that’s in front of us, even though our pleasure decreases as we eat. Sometimes we use finishing the packet as the signal to stop eating rather than hunger or desire.

Is there anything I can do to resist cravings?

We largely don’t have control over cues in our environment and the cravings they trigger. But there are some ways you can try and control the situations you make food choices in.

• Acknowledge your craving and think about a healthier way to satisfy it. For example, if you’re craving chips, could you have lightly-salted nuts instead? If you want something sweet, you could try fruit.
• Avoid shopping when you’re hungry, and make a list beforehand. Making the most of supermarket “click and collect” or delivery options can also help avoid ads and impulse buys in the aisle.
• At home, have fruit and vegetables easily available – and easy to see. Also have other nutrient dense, fibre-rich and unprocessed foods on hand such as nuts or plain yoghurt. If you can, remove high-fat, sugar-rich and salty foods from your environment.
• Make sure your goals for eating are SMART. This means they are specific, measurable, achievable, relevant and time-bound.
• Be kind to yourself. Don’t beat yourself up if you eat something that doesn’t meet your health goals. Just keep on trying.

Gabrielle Weidemann, Associate Professor in Psychological Science, Western Sydney University and Justin Mahlberg, Research Fellow, Pyschology, Monash University

This article is republished from The Conversation under a Creative Commons license. Read the original article.

Opioids are commonly prescribed when you’re discharged from hospital after surgery to help manage pain at home.

These strong painkillers may have unwanted side effects or harms, such as constipation, drowsiness or the risk of dependence.

However, there are steps you can take to minimise those harms and use opioids more safely as you recover from surgery.

Which types of opioids are most common?

The most commonly prescribed opioids after surgery in Australia are oxycodone (brand names include Endone, OxyNorm) and tapentadol (Palexia).

In fact, about half of new oxycodone prescriptions in Australia occur after a recent hospital visit.

Most commonly, people will be given immediate-release opioids for their pain. These are quick-acting and are used to manage short-term pain.

Because they work quickly, their dose can be easily adjusted to manage current pain levels. Your doctor will provide instructions on how to adjust the dosage based on your pain levels.

Then there are slow-release opioids, which are specially formulated to slowly release the dose over about half to a full day. These may have “sustained-release”, “controlled-release” or “extended-release” on the box.

Slow-release formulations are primarily used for chronic or long-term pain. The slow-release form means the medicine does not have to be taken as often. However, it takes longer to have an effect compared with immediate-release, so it is not commonly used after surgery.

Controlling your pain after surgery is important. This allows you get up and start moving sooner, and recover faster. Moving around sooner after surgery prevents muscle wasting and harms associated with immobility, such as bed sores and blood clots.

Everyone’s pain levels and needs for pain medicines are different. Pain levels also decrease as your surgical wound heals, so you may need to take less of your medicine as you recover.

But there are also risks

As mentioned above, side effects of opioids include constipation and feeling drowsy or nauseous. The drowsiness can also make you more likely to fall over.

Opioids prescribed to manage pain at home after surgery are usually prescribed for short-term use.

But up to one in ten Australians still take them up to four months after surgery. One study found people didn’t know how to safely stop taking opioids.

Such long-term opioid use may lead to dependence and overdose. It can also reduce the medicine’s effectiveness. That’s because your body becomes used to the opioid and needs more of it to have the same effect.

Dependency and side effects are also more common with slow-release opioids than immediate-release opioids. This is because people are usually on slow-release opioids for longer.

Then there are concerns about “leftover” opioids. One study found 40% of participants were prescribed more than twice the amount they needed.

This results in unused opioids at home, which can be dangerous to the person and their family. Storing leftover opioids at home increases the risk of taking too much, sharing with others inappropriately, and using without doctor supervision.

How to mimimise the risks

Before using opioids, speak to your doctor or pharmacist about using over-the-counter pain medicines such as paracetamol or anti-inflammatories such as ibuprofen (for example, Nurofen, Brufen) or diclofenac (for example, Voltaren, Fenac).

These can be quite effective at controlling pain and will lessen your need for opioids. They can often be used instead of opioids, but in some cases a combination of both is needed.

Other techniques to manage pain include physiotherapy, exercise, heat packs or ice packs. Speak to your doctor or pharmacist to discuss which techniques would benefit you the most.

However, if you do need opioids, there are some ways to make sure you use them safely and effectively:

• ask for immediate-release rather than slow-release opioids to lower your risk of side effects
• do not drink alcohol or take sleeping tablets while on opioids. This can increase any drowsiness, and lead to reduced alertness and slower breathing
• as you may be at higher risk of falls, remove trip hazards from your home and make sure you can safely get up off the sofa or bed and to the bathroom or kitchen
• before starting opioids, have a plan in place with your doctor or pharmacist about how and when to stop taking them. Opioids after surgery are ideally taken at the lowest possible dose for the shortest length of time.

If you’re concerned about side effects

If you are concerned about side effects while taking opioids, speak to your pharmacist or doctor. Side effects include:

• constipation – your pharmacist will be able to give you lifestyle advice and recommend laxatives
• drowsiness – do not drive or operate heavy machinery. If you’re trying to stay awake during the day, but keep falling asleep, your dose may be too high and you should contact your doctor
• weakness and slowed breathing – this may be a sign of a more serious side effect such as respiratory depression which requires medical attention. Contact your doctor immediately.

If you’re having trouble stopping opioids

Talk to your doctor or pharmacist if you’re having trouble stopping opioids. They can give you alternatives to manage the pain and provide advice on gradually lowering your dose.

You may experience withdrawal effects, such as agitation, anxiety and insomnia, but your doctor and pharmacist can help you manage these.

How about leftover opioids?

After you have finished using opioids, take any leftovers to your local pharmacy to dispose of them safely, free of charge.

Do not share opioids with others and keep them away from others in the house who do not need them, as opioids can cause unintended harms if not used under the supervision of a medical professional. This could include accidental ingestion by children.

For more information, speak to your pharmacist or doctor. Choosing Wisely Australia also has free online information about managing pain and opioid medicines.

Katelyn Jauregui, PhD Candidate and Clinical Pharmacist, School of Pharmacy, Faculty of Medicine and Health, University of Sydney; Asad Patanwala, Professor, Sydney School of Pharmacy, University of Sydney; Jonathan Penm, Senior lecturer, School of Pharmacy, University of Sydney, and Shania Liu, Postdoctoral Research Fellow, Faculty of Medicine and Dentistry, University of Alberta

This article is republished from The Conversation under a Creative Commons license. Read the original article.