Dr. Josie Recommends RESIST / Craving Prevention Support Formula

RESIST was developed by Dr. Josie L. Tenore because of awareness that many people struggle with food cravings and/or addictions.  After some extensive research into the nutrients/supplements that may be helpful, RESIST was created.  The following is a quick reference guide on the ingredients that were chosen and what their uses are, followed by a more detailed discussion on the entire topic of cravings, addiction and the role in weight management.

RESIST is a proprietary blend of N-acetyl-cysteine, Citicholine and Theanine.  What are these ingredients and what do they do exactly?

N-acetyl-cysteine [NAC]
NAC regulates the glutaminergic system in the brain, and so satisfies the reward centers of the brain, thus reducing compulsive behaviors and cravings.  As a weight loss aid, NAC aids fat loss by interfering with the interaction of insulin with the fat cells, hence preventing fat storage, and enhancing the mobilization of fat out of storage and used for energy at an accelerated rate.  In English this means: NAC stimulates those cells in the brain that cause the cravings.  It also doesn’t allow insulin to store fat; thereby the fat can be used for energy.

Citicoline plays a vital role in the support of neural functions such as mental alertness, focus and memory.  Studies have also shown that citicoline reduces food cravings and increases the levels of dopamine in people addicted to cocaine.  In people not addicted to cocaine, citicoline increases the responses of the brain to food stimulus that are linked with reduced appetite.  Just as NAC aids fat loss, so does citicoline accelerates the use of fat by the body and even prompts the liver to dispose of stored or trapped fats thereby helping the body to be more efficient in burning fat.  TRANSLATION: Citicoline also stimulates other cells in the brain to decrease cravings and decrease appetite.  It also tells the liver to get rid of fat.

Theanine is a supplement that enhances the effect of Gamma aminobutyric acid, elevates dopamine and serotonin and contributes to a decrease in the chemical reaction causing cravings and addictions.  TRANSLATION: Theanine stimulates the brain to release chemicals that helps to calm you and improve mood.

Food cravings

Food cravings constitute an impediment to people who desire to maintain a healthy weight, or are attempting to adapt a healthier diet.  Food craving or cravings of any form refers to an intense, often irresistible desire for a particular kind of food [or substance].  The desire is usually uncontrollable, and it may not be resolved until the person gets the substance they desired.

With respect to food cravings, some experts are of the opinion that food cravings usually last between 3 – 5 minutes, but for those who have cravings, this is either an underestimation, or it may feel like it is an underestimation.  People have different experiences of cravings, although most would say that they usually crave “junk” or heavily processed food.  In many cases, these foods are usually unhealthy and high in fat, salt and sugar.

The causes of food cravings are multi-factorial, meaning that there is a complex interaction involving more than one factor.  Physiologically, food craving is caused by a complex interaction between those areas of the brain that control pleasure, reward and memory and with hormonal imbalances, as well as pathways involving serotonin and leptin.

Pregnant women for instance experience strong cravings.  The cause is not completely clear but does involve hormonal changes that can cause a disruption in smell and taste receptors.  Cravings also have a connection with nutrients and nutrient deficiencies.  The concept is that the body craves certain foods because it is deficient in some nutrients that are present in those foods.  But, in some cases the deficiency can be so severe that individuals may eat substances that are not normally considered food as is demonstrated in the condition called PICA, whereby individuals eat dirt or paint neither of which have any nutritional value.  PICA can be seen in pregnant woman and children who are severely iron deficient.

Cravings may be selective or nonselective.  Selective cravings refer to the desire for specific foods, such as your favorite burger, or some other favorite or special foods.  Non-selective cravings, on the other hand refer to the desire to eat just anything edible or even inedible in the case of dirt or paint.  Non-selective cravings could be due to hunger pangs or real intense hunger, taste or even dehydration.  Intake of water helps combat intense non-selective cravings.

There is also some speculation that endorphins, when released into the body, may cause or contribute to the sensation that is experienced as a craving.  This is based on the observation that endorphins are usually released into the body after meals, which is the same process that occurs with addiction.  Strategies that my be helpful in reducing the symptoms of food cravings include; reducing stress levels [1], drinking sufficient amount of water, getting enough sleep [2], intake of sufficient proteins [3], and chewing gum [4].  Other tips may include a change of environment, regulating the portions of food you take each time, and avoiding hunger.

Food craving may also be triggered by emotions, especially if the person eats for comfort.  These are the most difficult to treat without psychological intervention and may not be help by this product.

Food addiction

Food addiction refers to a condition where a person is severely addicted to a particular kind of food, usually high fat, high sugar, highly processed, (aka Junk), in the same way that a drug addict would be addicted to drugs.  It usually involves the same brain regions, same neurotransmitters, and identical symptoms [5].  Food addiction is actually a new term and quite controversial.  There is not much research on the statistics of its prevalence, so we really do not know how common it is.

Food addiction is similar to other eating disorders such as bulimia, binge eating, compulsive overeating, and having some unhealthy relationship with food.

So how does addiction to food work?  Junk foods and processed foods greatly influence the brain’s reward centers, involving dopamine and other such neurotransmitters [6].  The most problematic foods in this category include foods such as “burgers and fries, pizza, mac and cheese, cookies, cake, pies” and other foods that contain wheat, sugar or both.

Food addiction may not be as a result of lack of willpower or anything of the sort.  Instead, it may be caused by the influence of dopamine on the brain’s biochemistry [7].   Symptoms that are typical of food addicts include:

• Frequent cravings for some specific foods, not minding the fact that one already has a feeling of fullness.
• Eating large quantities of a specific food (often the one that one craves).
• When one has the feeling of guilt after eating some foods, yet finds himself or herself eating it again soon after.
• When one sets rules about specific foods, and determines to quit eating them but is unsuccessful in keeping the resolution.
• Hiding your consumption of unhealthy foods from others.
• Inability to control one’s intake of unhealthy foods despite knowing the fact that they cause harm physically (through weight gain and consequently, obesity).

Weight management

Weight management techniques refer to strategies that promote consumption of healthy foods and engagement in physical activity [8].  Maintaining a healthy weight is very important.  If a person is obese, or underweight, then he or she may be at risk of some health disorders.  Studies have shown that at least two-thirds of adults in the US are obese or overweight [9].   Achieving a healthy weight helps one to control his blood pressure, cholesterol, and blood sugar levels.   It also helps in the prevention of weight-related illnesses, such as diabetes, heart disease, certain cancers and arthritis.

Being overweight may be caused by excessive intake of food or leading a sedentary and physically inactive lifestyle. To maintain the weight, the energy intake must be equal to energy expenditure. What this implies is that calorie intake must equal calorie used in physical activity.

While beyond the scope of this discussion, it can generally be stated that effective weight-management strategies may include:

• Consumption of low-fat foods and foods with a low-calorie content
• Sometimes consumption of high fat foods but excluding most carbohydrates as found in ketogenic diets
• Eating smaller portions
• Physical activity
• Drinking water rather than sugary foods.

The effect of N-acetyl-cysteine on food addiction, food craving and weight management

N-acetyl-cysteine is making waves as one of the very important supplements to support recovery.  There is a theory that compulsive behavior such as addiction to food is aided by the sub-optimal functioning of the glutaminergic system within the brain.  This leads to an increase in cravings and compulsive behavior.  It should be understood that N-acetyl-cysteine regulates the glutaminergic system in the brain, and so satisfies the reward centers of the brain, thus reducing compulsive behaviors and cravings.

A number of pilot studies, reports and randomized controlled trials have verified the effectiveness of N-acetyl-cysteine for food addiction, nicotine addiction, and being helpful for those who have a dependence on cannabis, cocaine addiction, and pathological gambling [10]. An effective dose may be 2,000 to 4,000mg once per day at least 40 minutes before breakfast. Studies have shown that this supplement is best taken without food. Not doing so will expose it to the degrading activities of dietary protein. N-acetyl-cysteine usually has no side effects. However, a few patients have made complaints of gastric upset.

On weight management, N-acetyl-cysteine may aid weight loss via its ability to improve the cells sensitivity to insulin.  This implies that with NAC, the body would be able to use insulin more efficiently.  The potential of NAC to affect insulin sensitivity may support weight loss because effective metabolism of insulin affects the ability of the body to use fat for energy.  Insulin is released by the beta cells of the pancreas as sugar gets into the blood stream. If the body does not make proper use of it (the insulin), it remains in the blood stream. High levels of insulin impede weight loss efforts because the hormone signals the body to keep the fat in storage.

Summarily, N-Acetyl-Cysteine aids fat loss by interfering with the interaction of insulin with the fat cells, hence preventing fat storage, and enhancing the mobilization of fat out of storage and used for energy at an accelerated rate [11].

The effect of citicoline on food addiction, food craving and weight management

Citicoline is a dietary supplement. It plays a vital role in the support of neural functions such as mental alertness, focus and memory.

The origin of this supplement can be traced to Japan where it was used for treatment of stroke patients.  The drug was later introduced in Europe where it was used for the treatment of cognitive impairments caused by poor circulation of blood to the brain. It is used as a dietary supplement in the United States.

Studies have shown that citicoline performs its functions by providing the building blocks for the synthesis of acetylcholine and phosphatidylcholine.  Phosphatidylcholine plays vital roles in the production of membranes for brain cells. Acetylcholine on the other hand serves as a neurotransmitter for memory functions [12].  Citicoline increases the metabolism of glucose in the brain. It also enhances the flow of blood to and from the brain (cerebral blood flow) [13].

Studies have shown that citicoline reduces food cravings and increases the levels of dopamine in people addicted to cocaine [14].   In people not addicted to cocaine, citicoline increases the responses of the brain to food stimulus, especially in the insula, the lateral orbitofrontal cortex, and the amygdala which are linked with reduced appetite [15].  It should be understood that this supplement may reduce appetite in humans at doses of 2,000mg daily.   Why this happens is not fully understood [16].

On its role in weight management, research has shown that citicoline helps in efficient burning of fat.   Choline is a micronutrient that has a lipotropic property. What this implies is that it accelerates the use of fat by the body, and even prompts the liver to dispose of stored or trapped fats [17].   Studies [17] have shown that using choline in a weight loss program may give positive results.   Though it may not be classified as the best or most potent weight-loss supplement, it uses a natural mechanism of action – with zero side effects, making it one of the most-desired.

Choline accelerates lipolysis, meaning that it helps burns fat at a faster rate than you would with the normal metabolic rate.   It does this by facilitating movement of dietary fats through all cells of the body so that they can be burned for energy. It is believed that this is the mechanism it deploys to prevent excessive weight gain, while also promoting a gradual and steady weight loss.

Potential role of Theanine in food cravings and addiction

Theanine enhances the effect of Gamma aminobutyric acid and contributes to decreasing food addictions and cravings. [27] Theanine also elevates the levels of dopamine and serotonin. These neurotransmitters play a vital role in regulating appetite. By elevating their levels, theanine indirectly potentiates their appetite-stimulating and or inhibitory effects.

Josie L. Tenore, M.D., M.Sc.

1. Macedo DM, Diez-Garcia RW. Sweet craving and ghrelin and leptin levels in women during stress. Appetite. 2014 Sep; 80:264-70.
2. Markwald RR, Melanson EL, Smith MR, et al. Impact of insufficient sleep on total daily energy expenditure, food intake, and weight gain. Proceedings of the National Academy of Sciences of the United States of America. 2013; 110(14):5695-5700.
3. Leidy HJ, Tang M, Armstrong CLH, Martin CB, Campbell WW. The Effects of Consuming Frequent, Higher Protein Meals on Appetite and Satiety during Weight Loss in Overweight/Obese Men. Obesity (Silver Spring, Md). 2011; 19(4):818-824.
4. Hetherington MM, Regan MF. Effects of chewing gum on short-term appetite regulation in moderately restrained eaters. Appetite. 2011 Oct; 57(2):475-82.
5. Blumenthal, Daniel M; Gold, Mark S. Neurobiology of food addiction. Current Opinion in Clinical Nutrition & Metabolic Care: July 2010; 13: (4):359–365
6. Rada P, Avena N, Hoebel B. Daily bingeing on sugar repeatedly releases dopamine in the accumbens shell. Neuroscience. 2005; 134(3): 734-744.
7. Avena NM, Rada P, Hoebel BG. Evidence for sugar addiction: Behavioral and neurochemical effects of intermittent, excessive sugar intake. Neuroscience and biobehavioral reviews. 2008; 32(1):20-39.
8. Tiepkema, M. (2004) Measured Obesity: Adult obesity in Canada: Measured height and weight. Nutrition: Findings from the Canadian Community Health Survey 1: 1-10
9. Matthew M, Jon R, Brian M, Mogen M, David B and SuJean C. N-acetylcysteine (NAC) decreases binge eating in a rodent model. International Journal of Obesity. 2016; 40(7): 1183-1186.
10. Kersick C, Willoughby D. The antioxidant Role of Glutathione and N-Acetyl-Cysteine Supplements and Exercise-Induced Oxidative Stress. Journal of the International Society of Sports Nutrition. 2005; 2: 38-44.
11. Pawel G. Neuroprotective Properties of Citicoline: Facts, Doubts and Unresolved Issues. CNS Drugs. 2014; 28(3): 185-193.
12. Watanabe S, Kono S, Nakashima Y, Mitsunobu K, Otsuki S. “Effects of various cerebral metabolic activators on glucose metabolism of brain”. Folia Psychiatrica et Neurologica Japonica. 1975; 29 (1): 67–76.
13. Renshaw PF, Daniels S, Lundahl LH, Rogers V, Lukas SE. “Short-term treatment with citicoline (CDP-choline) attenuates some measures of craving in cocaine-dependent subjects: a preliminary report”. Psychopharmacology. 1999; 142 (2): 132–8.
14. Killgore WD, Ross AJ, Kamiya T, Kawada Y, Renshaw PF, Yurgelun-Todd DA. “Citicoline affects appetite and cortico-limbic responses to images of high-calorie foods”. The International Journal of Eating Disorders. 2010; 43 (1): 6–13.
15. Silveri M, et al. Citicoline enhances frontal lobe bioenergetics as measured by phosphorous magnetic resonance spectroscopy. NMR Biomed. (2008).
16. William D, et al. Citicoline Affects Appetite and Cortico-Limbic Responses to Images of High Calorie Foods. Int J Eat Disord. 2012; 43(1): 6-13.
17. Ammon H, Muller P. Forskolin: from an ayurvedic remedy to a modern agent. Planta Med. 1985 Dec; 51(6):473-7.
18. Hor R, Shi Q. Forskolin as a novel lipolytic agent. Biochem Biophys Res Commun. 1982; 107(1):157-64.
19. Litosch I, Hudson TH, Mills I, Li SY, Fain JN. Forskolin as an activator of cyclic AMP accumulation and lipolysis in rat adipocytes. Mol Pharmacol. 1982; 22(1):109-15.
20. Hermansen K. Forskolin, an activator of adenylate cyclase, stimulates pancreatic insulin, glucagon, and somatostatin release in the dog: studies in vitro. Endocrinology. (1985).
21. NADH: The many benefits of NAD+. https://www.stronghealth.com/nadh-benefits-nad/#Health_Benefits_of_nicotinamide_adenine_dinucleotide
22. Palmer LA, et al. S-nitrosothiols signal hypoxia-mimetic vascular pathology. J Clin Invest. (2007)
23. Parisi V, et al. Cytidine-5′-diphosphocholine (citicoline) improves retinal and cortical responses in patients with glaucoma. Ophthalmology. (1999)
24. Hermansen K. Forskolin, an activator of adenylate cyclase, stimulates pancreatic insulin, glucagon, and somatostatin release in the dog: studies in vitro. Endocrinology. (1985)
25. [No authors listed]. Coleus forskohlii. Monograph. Altern Med Rev. (2006)
26. Kahn SE, et al. Increased beta-cell secretory capacity as mechanism for islet adaptation to nicotinic acid-induced insulin resistance. Diabetes. (1989)
27. Kimura R, Murata T. Influence of alklylamides of glutamic acid and related compounds on the central nervous system. I. Central depressant effect of theanine. Chem Pharm Bull (Tokyo). 1971.