Is Sugar Addiction a Substance Use Disorder?

Is Sugar Addiction a Substance Use Disorder? An Examination of Sugar Addiction as a Substance Use Disorder Abstract In the last decade, many studies have supported the addictive nature of sugar. In this examination of sugar addiction, we explore the parallels with substance abuse disorder and highlight the effects on the brain and body as well as the psychological and biological risk factors that may make an individual vulnerable to sugar addiction. We theorize that defining sugar addiction as a substance abuse disorder in a future version of the Diagnostic and Statistical Manual of Mental Disorders (DSM) will change policy to improve public health, and minimize the costs of metabolic disorders like diabetes, obesity, and heart disease on the economy. Keywords: sugar addiction, substance use disorder, dopamine, impulsivity, obesity Worldwide obesity rates are rapidly rising. In 2016, an estimated 30% of Americans over the age of 18, and almost 20% of young adults were overweight or obese, as defined by a body mass index (BMI) greater than 30 (Centers for Disease Control and Prevention, 2016); and they are projected to increase to 80% by 2023 (Wang, Beydoun, Liang, Caballero, & Kumanyika, 2008). Between 29% and 47% of obese individuals meet the criteria for binge eating disorders (BED) (McCuen-Wurst, Ruggieri, & Allison, 2017). However, we suggest in this review of the literature that the food addiction model is a more appropriate mechanism when looking at correlates and causes of the development of eating disorders and metabolic disorders, including insulin resistance, diabetes, and obesity. The DSM-5 criteria for BED is limited in that it focuses largely on behavior, distress and shame caused by the eating disorder, and lacks acknowledgment of the neurobiological vulnerabilities and effects (American Psychiatric Association, 2013a). Alternatively, the food addiction model proposes that food, especially highly palatable, processed foods that are high in sugar, fat and/or salt are addictive (Davis & Carter, 2014), and therefore may be the underlying cause of BED and metabolic disorders, including obesity. For this examination, we mainly focus on the addictive nature of sugar, as the majority of food addiction studies have shown that sugar intake is more addictive than fat or salt, and highlight the numerous biological and psychological parallels to substance (Avena, Bocarsly, Rada, Kim, & Hoebel, 2008; Avena, Rada, & Hoebel, 2008; Davis, Loxton, Levitan, Kaplan, Carter, & Kennedy, 2013; Hoebel, Avena, Bocarsly, & Rada, 2009; Hone-Blanchet & Fecteau, 2014; Ifland, Preuss, Marcus, Rourke, Taylor, Burau, Jacobs, Kadish, & Manso, 2009; Page & Melrose, 2016; Tran & Westbrook, 2017; Wong, Dogra, & Reichelt, 2017). It is well known that addictive drugs activate the dopaminergic reward pathway. The mesocorticolimbic pathway, which includes the ventral tegmental area (VTA), nucleus accumbens (NAc) and the frontal cortex, is especially implicated in the reinforcement of the use of these substances. These areas release high levels of dopamine, which produce a euphoric state, and help form â€Å"liking† motivations and positive associations toward the addictive substances. However, as the drug is repeatedly consumed, tolerance builds in the body, and â€Å"liking† becomes â€Å"wanting,† resulting in reduced pleasure, and physiological dependence that necessitates increased consumption (Reeve, 2015). Food addiction studies have shown that while a variety of foods lead to the release of dopamine, sugar activates the dopaminergic pathway in a way that mirrors addictive substances, and leads to bingeing, tolerance, cravings, dependence, and subsequent withdrawal symptoms when deprived (American Psychiatric Association, 2013b; Avena et al., 2008; Davis & Carter, 2014; Davis et al., 2013). As sugar is over-consumed, tolerance grows and bingeing with increased amounts of sugar are needed to obtain the same pleasurable effect. This is suggested to be due to the down-regulation of dopamine receptors (Avena et al., 2008; Davis, Patte, Levitan, Reid, Tweed, & Curtis, 2007; Hoebel et al., 2009; Ifland et al., 2009, Loxton & Tipman, 2017). Thereafter, â€Å"wanting† or cravings are suggested to be due to the imbalance of hormone signals that results in high anticipation and high sensitivity to sugar when it is consumed. In a study conducted by Lindqvist, Baelemans, and Erlanson-Albertsson (2008), rats that were given a sugar solution showed a 40% increase in ghrelin, the hormone that triggers appetite; in contrast to a significant decrease in leptin and peptide YY, two hunger-suppressing hormones; and a significant down-regulation in mRNA expression of additional hunger-suppressing peptides. This imbalance of appetite hormones and gene expression were hypothesized to have resulted in bingeing and tolerance, as demonstrated by a doubling of the drink consumption compared to control-group rats given water. Lastly, animal studies on sugar addiction have shown that sugar withdrawal mimics opioid withdrawal, and presents with depression and anxiety when deprivation of sugar occurs (Avena et al., 2008; Avena, Rada, & Hoebel, 2008; Hoebel et al., 2009; Hone-Blanchet & Fecteau, 2014; Ifland et al., 2009). The numerous studies in sugar addiction that overlap with the different stages of substance use disorders provide strong biological support for sugar addiction to be classified as a substance use disorder. Further adding to the biological susceptibility of sugar addiction, Davis et al. (2013) found enhanced dopamine transmission was due to six genetic mutations linked to the dopamine reward pathway; and that association between increased dopamine signaling and multilocus genetic profile scores was significantly higher in participants with high reward sensitivity and high risk for food addiction. These neurological changes and genetic vulnerabilities support tolerance and dependence that may result from a frequent flooding of dopamine and a reduction of receptors as seen in substance use disorders. Likewise, psychological traits like impulsivity and poor emotional regulation, have been found in both substance use disorders and sugar addiction. Impulsivity, as it relates to immediate gratification and deficits in behavioral inhibition, was positively correlated with sugar addiction. However, sensation-seeking, as an impulsive personality trait, was negatively associated with sugar addiction, and theorized to be due to the lack of arousal and stimulation from eating food; â€Å"those who are risk seeking and reward-driven might seek out experiences involving greater levels of arousal and stimulation (Pivarunas & Connor, 2015; VanderBroek-Stice, Stojek, Beach, vanDellen, & MacKillop, 2017). Poor emotional regulation and low distress tolerance were also positively associated with sugar addiction, and the consumption of sugar was hypothesized to activate the pleasure center countering the negative emotional state and further reinforcing the reward of sugar intake behavior (Kozak & Fought, 2011; Pivarunas & Connor, 2015). Equally important in the comparison between sugar addiction and substance use disorders are the detrimental effects on the brain and body’s functions, such as cognitive impairment and metabolic disorders. Reversible cognitive impairments in decision-making, motivation, spatial or place-recognition memory were recently identified in studies with rats (Tran & Westbrook, 2017; Wong, Dogra, & Reichelt, 2017). However, in a study conducted by Page and Melrose (2016), high levels of circulating sugar and insulin levels dulled food cues, reducing hypothalamic activity, and negatively affecting neural food processing, which over time increased the risk for insulin resistance, type 2 diabetes, and obesity. A separate study found that the overconsumption of sugar increased levels of free fatty acids, triglycerides and cholesterol in the blood (Lindqvist, Baelemans, & Erlanson-Albertsson, 2008), which are confirmed risk factors for developing in heart disease and strokes in humans (National Institute of Health, 2005; American Heart Association, 2017). The relationship between sugar addiction’s detrimental effects and long-term illness are apparent in the literature, and is analogous to the relationship between substance use and disease. Current treatment options for food or sugar addiction are limited to exercise, which addresses biological pathways; and mindfulness, which emphasizes psychological processes. Exercise serves as a protective treatment against metabolic disorders and food addiction via increases in brain-derived neurotropic factor (BDNF), a neurotransmitter that plays a major role in neuroplasticity, and in the regulation of food intake, physical activity, and glucose metabolism (Codella, Terruzzi, & Luzi, 2017). Whereas, mindfulness addresses the dual process model of health behavior, which states that there are interactive automatic (implicit) and controlled (explicit) psychological processes that result in addictive behavior. Implicit, automatic processes include intentions, approach and avoidance tendencies, and emotions, meanwhile explicit, controlled processes include reflective action (Hagger, Trost, Keech, Chan, & Hamilton, 2017; Tang, Posner, Rothbart, & Volkow, 2015). In 2017, Kakoschke, Kemps, & Tiggemann showed that a two-pronged approach-modification protocol successfully retrained participants to avoid unhealthy food by 1) reducing the approach bias toward unhealthy food, and 2) increasing the approach bias toward healthy food. Another study showed a high approach tendency for healthy food buffered against the stress of hunger and wanting for unhealthy food (Cheval, Audrin, Sarrazin, & Pelletier, 2017). Mindfulness was also found to regulate emotional reactivity to internal and external cues (Fisher, Mead, Lattimore, Malinowski, 2017). Unfortunately, available treatment options have low generalizable, replicable success as they fail to provide a streamlined approach to sugar addiction and/or address neurobiological vulnerabilities and negative effects. Neither sugar nor food addiction is currently defined in the DSM-5. The only consistent measure of food addiction is the Yale Food Addiction Scale (YFAS), a survey developed in 2009, and it is used in studies reliably as its questions are based on DSM-IV addiction criteria (Gearhardt, Corbin, Brownell, 2009; Gearhardt, Corbin, Brownell, 2016). As mentioned earlier, food addiction and BED are not reciprocal disorders, therefore acknowledging sugar addiction as a substance use disorder in a future DSM may increase evidence-based research that strongly implicates genetic and brain pathways, which may lead to early prevention, reduced stigmatization and diverse treatment options that address the psychological as well as neurobiological vulnerabilities through medication, and even gene therapy. Further research and government regulation can also limit the pseudo-science funded by sugar and packaged goods companies. For example, in reviewing the literature, two studies were found that denied sugar and its addictive properties (Benton, 2010; Markus, Rogers, Brouns, & Schepers, 2017); they were funded by Coca-Cola and the World Sugar Research Organization. Similar to the studies conducted by the tobacco industry, the information countering sugar addiction can be confusing and deceptive to consumers. Government regulation of the sugar industry, like the tobacco industry can result in a decrease of sugar addiction and its harmful health effects. Lastly, there is also a large benefit to public health and the economic costs in treating sugar addiction like a substance use disorder. The costs to treat diabetes, a disease directly related to increased blood sugar levels and insulin resistance was $245 billion in 2012 (Centers for Disease Control and Prevention, 2017). These costs do not include comorbid diseases like obesity, hypertension, and hyperlipidemia. Obesity alone is projected to cost upwards of $957 billion by 2030 (Wang et al., 2008). Therefore, prevention of these life-long metabolic disorders by addressing the addictive properties of sugar can potentially reduce the burden on global health and economic systems in a great way. References American Heart Association. (2017). Prevention and Treatment of High Cholesterol (Hyperlipidemia). Retrieved from http://www.heart.org/HEARTORG/Conditions/Cholesterol/PreventionTreatmentofHighCholesterol/Prevention-and-Treatment-of-High-Cholesterol-Hyperlipidemia_UCM_001215_Article.jsp#.WhoJdNy1uUl American Psychiatric Association. (2013a). Feeding and Eating Disorders. In Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Arlington, VA: American Psychiatric Association. Retrieved from https://doi.org/10.1176/appi.books.9780890425596.dsm10 American Psychiatric Association. (2013b). Substance-Related and Addictive Disorders. In Diagnostic and statistical manual of mental disorders: DSM-5 (5th ed.). Arlington, VA: American Psychiatric Association. Retrieved from https://doi.org/10.1176/appi.books.9780890425596.dsm16 Avena, N. M., Bocarsly, M. E., Rada, P., Kim, A., & Hoebel, B. G. (2008). After daily bingeing on a sucrose solution, food deprivation induces anxiety and accumbens dopamine/acetylcholine imbalance. Physiology & Behavior, 94, 309-315. doi:10.1016/j.physbeh.2008.01.008 Avena, N. M., Rada, P., & Hoebel, B. G. (2008). Evidence for sugar addiction: Behavioral and neurochemical effects of intermittent, excessive sugar intake. Neuroscience and Biobehavioral Reviews, 32, 20-39. doi:10.1016/j.neubiorev.2007.04.019 Benton, D. (2010). The plausibility of sugar addiction and its role in obesity and eating disorders. Clinical Nutrition, 29, 288-303. doi:10.1016/j.clnu.2009.12.001 Cheval, B., Audrin, C., Sarrazin, P., & Pelletier, L. (2017). 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In Understanding Motivation and Emotion (6th ed.). Hoboken, NJ: Wiley. Tang, Y., Posner, M. I., Rothbart, M. K., & Volkow, N. D. (2015). Circuitry of self-control and its role in reduction addiction. Trends in Cognitive Sciences, 19(8), 439-444. doi:10.1016/j.tics.2015.06.007 Tran, D. M. D., & Westbrook, R. F. (2017). A high-fat high-sugar diet-induced impairment in place-recognition memory is reversible and training dependent. Appetite, 110, 61-71. doi:10.1016/j.appet.2016.12.010 U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. (2017). National Diabetes Statistics Report, 2017: Estimates of Diabetes and its Burden in the United States. Retrieved from https://www.cdc.gov/diabetes/pdfs/data/statistics/national-diabetes-statistics-report.pdf U.S. Department of Health and Human Services, Centers for Disease Control and Prevention. (2016). Nutrition, Physical Activity, and Obesity Behavioral Risk Factor Surveillance System: Percent of adults aged 18 and older who have obesity. Retrieved from https://chronicdata.cdc.gov/Nutrition-Physical-Activity-and-Obesity/Percent-of-adults-aged-18-and-older-who-have-obesi/cwdv-83mi U.S. Department of Health and Human Services, National Institutes of Health, National Heart, Lung, and Blood Institute. (2005). High blood cholesterol: What you need to know. (NIH Publication No. 05-3290). Retrieved from https://www.nhlbi.nih.gov/health/resources/heart/heart-cholesterol-hbc-what-html VanderBroek-Stice, L., Stojek, M. K., Beach, S. R. H., vanDellen, M. R., & MacKillop, J. (2017). Multidimensional assessment of impulsivity in relation to obesity and food addiction. Appetite, 112, 59-68. doi:10.1016/j.appet.2017.01.009 Wang, Y., Beydoun, M. A., Liang, L., Caballero, B., & Kumanyika, S. K. (2008). Will all Americans become overweight or obese? 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Economic Impact Of The Development Of Airline Industry Essay

Hardly many inventions can manage to change the way people live and also how they experience the world like the way inventing airplane has done. The airline industry offer air transport for passengers. The airlines companies own the airplanes or may lease them. Airlines Company differs in terms of capacity, some are smaller with one or two airplanes to transport mail and cargo, while other are big multinational companies with hundreds of aircrafts. Majority of airlines are privately owned, though some are government owned. Today, the air travel has grown to an extent that no one can imagine life without it. Air travelling as greatly reduced travelling time and opened up links all over the world. Economic Impact of the development of airline The air airline industry has played a major role in world economic growth; it has improved the mobility and facilitated world supply lines all over the world. The aviation industry not only serves as an economic tool for nations and cities, but also servers as a vital network for transport within the world. The industry creates jobs by providing them directly and also by creating opportunities in the travel and hotel industry. Aviation industry has continued to be critical in the world economy, in terms of creating these job opportunities, and the industry has employed thousands of employees in the whole world. And has the industry continue to grow more jobs are created. This leads to economic growth. Transport plays a major role in making sure that goods reach their destinations. The World Bank estimates that the airline industry contributes to a total of 5% economic growth in the world. Competition Competition in the industry can be traced back when most governments deregulated the industry I order allow competition among the industry to regulate fares. For many years now this resulted in low fares as the airline industry responded to customers needs. Most of the reduced fare also comes from new players on the market, and also from the big airlines themselves. With the growth of economy in many countries, more travellers are using the air, this id due to the fact that the fares have also been reducing gradually. In a report carried out in America by the senate, it was found out that competition has resulted into low fares, and from 1990 the traffic has gone up by over 33%, it was found out that the number of flights had also gone up to over 20%. This of course has a positive impact on economic growth. Competition in the industry has also lead to mergers as small companies fail to compete. This has improved the industry service delivery. It is important to note better service delivery has economic advantage. With the economic development being witnessed in many countries, the amount of travelling has gone up. Many people are travelling to transact their business. The high demand of air passengers has caused resource constraints, on airports and also on airways, especially during the peak travelling periods. Business community usually travels at these times and normally makes last minute bookings. However, main airlines have planned their networks to be able to meet the high rate flight requirement by the business passengers, though; these fares are expensive as the airlines need to cover cost of servicing high number flight. Nevertheless, airline competition and the way they price their tickets causes concerned. It has been noted that, with the emerging of low fare trends that have been occurring since 1996, when smaller airlines enter into this market with low fares, the major airlines drastically reduce their prices. And also avail a high number of low fare seats. This behaviour seems to be ill intended because it aims at repressing competition from the smaller airlines. Increase in fuel prices Oil and fuel prices have continuously increased for the past 10 years, for example, in 2001 the price per barrel was $20, yet in 2006 it had reached $75. The increase in price can be attributed to various such as, high demand of oil, collapse of Yukos Oil Company in Russia and political instability in the Middle East. This high increase in oil prices has affected the aviation industry. The increase in fuel prices has lead to reduction in the global trade. It is estimated that about 40% of goods traded on the world market are transported by the air, and cargo traffic is used to reflect economic growth. Fuel account for 20-30% of the total cost of operation expenses of the airline industry. Due to this high cost in oil the economy has suffered negatively. The microeconomic effect for those countries which import oil will be harsh, in the industry high prices is a big problem; the companies are forced to increase consumers’ fares to upset the fuel price increase, for example if fuel price reached 100$ per barrel, then a gallon of jet fuel will be more than 3$. This will imply that a passenger will have to pay 50$ more to travel than previous. This will result in reduction of passengers and for the case of cargo transporters it may lead to high reduction in demand of their services, which may spell down for the airline companies. The indirect impact on the airline industry caused by high fuel prices in the increase in airline products prices. The overall impact is reduction in international trade. As pointed out by the world trade organisation , increase in oil prices leads to low economic growth as it was observed in 2005. Terrorist threat Since the September 11 terrorist attack, the airline industry suffered so much, the industry experience a reduced number of passengers as many opted to use alternative means. The economic impact on the global level was immerse, has many countries experienced low foreign exchange due reduced business especially in tourism industry. The terrorist attack had a big effect on the aviation industry, and also on the economy. In America alone, more than 2 million passengers travel on air daily. Airline industry and tourism alone account for mote than 8% the world GDP. With the imminent threat of terrorism, the industry has undertaken different security measures. For example in America, the industry has to use over 11$ billion in security improvements. This costs at the end of the day have to be met by the passengers, thus, the fare in the industry have steadily gone up. This has reduced the volume of goods and passengers using the industry and negatively affected the economy. Any small distractions in the industry send shock waves in many other industries. Currently, the industry has experienced a trend by which they are weak economy, insecurity fear and other issues. This has led to reduced number of passengers flying. Even those passengers who are flying they are paying less because most of them are taking economy seats. This trend has resulted in decline of the growth of the industry. In decline in the industry usually result in reduction of economy growth of the world economy. After the September 11 many airline companies grounded their business due to security concerns this was so pronounced in America. The impact of the attack reverberated all over the world. It was estimated that the attack caused a reduction of 1% world economic growth. In this area of global economy the aviation industry all over the world suffered. The industry saw an increase in costs of airline insurance, increased expenses on security, and customer fear to travel using the air due to insecurity. This led to massive losses for the industry in the whole world. This was the worst disaster the industry had suffered in the past 50 years. In whole world more than 400,000 jobs were lost. Decline in the air travel has a direct consequence on number of business which includes tourism, travel agencies and entertainment spots, this is felt global. It is important to note that, in the continuous threat of terrorist, the world economy has been affected badly. The industry had to go through lean times and some companies had to shut down. Conclusion The airline industry is very important in economic development, the airline employees a lot of people directly and indirectly. The industry has developed steadily over the last 50 years, and has continuous grown. Competition, fuel increase and terrorist attack pose a serious challenge to the industry and the industry should come up with ways to controlling these effects to maintain profitable. However, the airline industry will continue to grow though, it will be faced with more challenges.

The Indisputable Reality About Stat of a History Essay Argument Samples That Nobody Is Sharing With You

The Indisputable Reality About Stat of a History Essay Argument Samples That Nobody Is Sharing With You When you've narrowed your Topic, you are going to want to set up a purpose for your essay. You should locate a subject. You must explore a great deal of historical facets that are brought up in your essay, and learn how to make a correct analysis of said aspects. In general, most college-level essays should include a minumum of one major source and many secondary ones. Additionally it's one of the criteria of an amazing historical essay. Furthermore, it's among the criteria of an excellent historical essay. The Debate Over Stat of a History Essay Argument Samples An additional way to write an outstanding conclusion is to, once more, point out why your research is beneficial. An excellent structure will support an excellent argument. As soon as you've performed the initial research on your subject, you will receive at least some overall idea for the major argument. Initially, you've got to do a preliminary research on the topic so as to design a working argument. Essay readers would like to get insightful writing. People today make up their minds about the characteristic of a paper within th e very first few lines, therefore it's vital that you start strong. While you may discover several decent samples on the web, we still advise you to get in contact with a professional academic writing agency and request an original, top quality sample. Therefore, you should assume they already know the definitions of the essential terms you're using, or equipped to look them up on their very own moment. It is possible to also use the CRAAP test to see whether your source is credible. The Tried and True Method for Stat of a History Essay Argument Samples in Step by Step Detail The next thing you ought to concentrate on in the event that you are fighting to understand how to compose a history essay is the topic. Following that, you continue to introduce the value of a topic in question. If you're assigned with a specific topic, so you ought to dwell on the prescribed issue. By the end, you've got to again drag the context of the subject and put forth the thought of the whole research in jest. If you would like to earn a particular analysis, so you need to select a narrow topic that will specify just one or several aspects of some area of study. Make certain you distinguish the crucial questions from the sub-questions. Research the chosen topic and apply the info you uncover to make an outline. Top Stat of a History Essay Argument Samples Choices Through the upcoming few pages, you can locate the ultimate guide to writing history essays. History is more of narration, which means you will need to perfect your descriptions to meet your audience. You should recognize that different essays (and unique tutors, courses, and kinds of history) lend themselves to unique approaches. If you must do outside research, the UCLA library system provides a great deal of resources. Also, do not forget that your college or university might also have an on-line database. Other students become intimidated before a fantastic scope of topics. The Pain of Stat of a History Essay Argu ment Samples Consider what facts may be used to demonstrate the argument of each paragraph. Your questions is going to be the start of your own thesis. You will continue to demonstrate your thesis statement in the principal body of a history essay. A thesis statement is a brief sentence that states what your essay is likely to cover. Using Stat of a History Essay Argument Samples Though it educates on a vast war, it isn't political. The key point to remember is you don't use a History essay to tell a story for the interest of it. The conclusion is the previous portion of your essay that everyone will read, so it's important that it's also as strong as the introduction.

Understanding Aber and Sondern in German

​Conjunctions are words that link two sentences. In German, they belong to the group of non-declinable words, which means that they never change, no matter what case you think you should use or what gender a following noun has. However, while in English you might only have one option, in German you will often find several possibilities to choose from.  Such is the case with aber and sondern, which your dictionary will most certainly translate both as but. Using but in German Take a look at the following sentences: The child didnt want to go home, but to the park. Das Kind will nicht nach Hause gehen, sondern zum Park. I dont understand what you say, but you will certainly be right. Ich verstehe nicht, was Sie sagen, aber Sie werden schon Recht haben. She is exhausted but doesnt want to go to sleep. Sie ist erschà ¶pft aber will nicht schlafen gehen. As you can see, both aber and sondern mean but in English. How do you know which but conjunction to use? It is actually quite simple: Aber, which means but or however,  is used after either a positive or negative clause. On the other hand, sondern is only used after a negative clause when expressing a contradiction. In other words, the first clause of the sentence must contain either nicht or kein, and the second part of the sentence must contradict the first part of the sentence. Sondern can be best translated as  but rather. Carusos Little Brother Helps You to Create Better Sentences One last thing: aber and sondern are so called ADUSO-words. ADUSO is an acronym for: Aaber (but)Ddenn (because)Uund (and)Ssondern (contradicting but)Ooder (or) Those conjunctions all take position zero in a sentence. To remember that, you might want to think of ADUSO as the little brother of Enrico Caruso, the great opera singer. But he never grew out of his famous brothers shadow and remained quite a loser. Imagine the o in loser as a zero to remember position zero. A Little Quiz Lets test your knowledge. Which German version of but would you use in the following sentences? Ich komme nicht aus England _____ aus Schottland. I dont come from England but from Scotland. Ich bin hungrig, _____  ich habe keine Zeit etwas zu essen. I am hungry, but I dont have time to eat something. Sie spricht drei Sprachen: Englisch, Russisch, und Arabisch, _____ leider kein Deutsch. She speaks three languages: English, Russian, and Arabic, but unfortunately no German. Wir hà ¤tten gerne drei cheeseburger _____ ohne Zwiebeln. We would like (to have) three cheeseburgers but without onions. Er hat keinen Kartoffelsalat mitgebracht, _____  Nudelsalat. He didnt bring potato salad, but noodle salad. Er hat gesagt, er bringt Kartoffelsalat mit, _____ er hat Nudelsalat mitgebracht. He said, hed bring potato salad, but he brought noodle salad. Answers to the Quiz Ich komme nicht aus England,  sondern  aus Schottland.Ich bin hungrig,  aber  ich habe keine Zeit etwas zu essen.Sie spricht drei Sprachen: Englisch, Russisch und Arabisch  aber  leider kein Deutsch.Wir hà ¤tten gerne drei Cheeseburger,  aber  ohne Zwiebeln.Er hat keinen Kartoffelsalat mitgebracht, sondern  Nudelsalat.Er hat gesagt, er bringt Kartoffelsalat mit,  aber  er hat Nudelsalat mitgebracht.