Sweet Necessity: The Extent and Perils of Sugar Addiction
Telling a sugar addict to stop eating sugar is like telling an alcoholic to stop drinking.
Yeah. Yeah. Yeah. You’ve heard it before—sugar is bad for you. But, just how bad? According to Action on Sugar, a group of leading medical and nutrition experts, the sweet substance is bad enough that earlier this year, the group called for a 20-30% reduction in sugar added to packaged and processed foods over the next three to five years. Action on Sugar estimates that this change would result in a reduction of about 100 calories each person eats daily, and over time would reverse the obesity epidemic.
“Telling people to stop eating sugar is well-intended and might work for those who are not addicted to it,” says Kathleen DesMaisons, PhD, author of The Sugar Addict’s Total Recovery Program and Potatoes Not Prozac. “But it’s likely that many people who are obese or who have Diabetes Type 2 are sugar addicts. Telling them to stop eating sugar is like telling an alcoholic to stop drinking. There is much more to it than that.”
There is a lot of pain associated with this addiction. It’s real.
Nicole Avena, PhD, research neuroscientist and faculty member at the New York Obesity Research Center, agrees. “We’ve done lots of studies looking at what sugar can do to your brain, and we find that when some people eat too much sugar it can cause the release of the chemicals associated with pleasure and reward. Over time, their brains adapt to that and it down-regulates the receptors for these chemicals, so eventually they feel like they’re not getting enough pleasure out of the food they eat, and so they want to eat more and more of it,” she says.
Just like alcohol?
More and more research is showing the link between a dependence on sugar and addiction to other substances. A study that Avena helped conduct, published in 2007 in the Neuroscience & Biobehavioral Reviews, reported that in some circumstances, intermittent access to sugar can lead to behavior and neurochemical changes that resemble the effects of a substance of abuse. The study showed that rats with intermittent access to food and a sugar solution can show both a constellation of behaviors and parallel brain changes that are characteristic of rats that voluntarily self-administer addictive drugs.
A 2011 study of more than 500 people showed that those who had genetic changes in a hormone called ghrelin, which tells the brain you’re hungry, consumed more sugar (and alcohol) than those that had no gene variation. Researchers think that the genetic components that effects people’s ghrelin release may determine if they use sugar to enhance a neurological reward system.
In a 2012 paper in the journal Nature, researchers suggested that, like warnings on alcohol, limitations and warnings should be placed on products containing sugar. The paper included evidence that fructose and glucose in excess can have a toxic effect on the liver; the metabolism of ethanol - the alcohol contained in alcoholic beverages - had similarities to the metabolic pathways that fructose took. The authors also reported that sugar increased the risk for some of the same chronic conditions as alcohol does. “We need to do more studies to understand the overlap and comorbidity between substance abuse and food addiction. However, there is long-standing literature of becoming overweight after one quits having substance addiction. So people who get clean from drugs, smoking, and alcohol, gain weight. It seems they replace that urge with a food addiction,” says Avena.
DesMaisons says she noticed a clear connection between sugar and alcohol while working in a treatment center during the 1980s. “I worked with many alcoholics, and I’d ask them what they ate. Many said they ate lots of sugar and didn’t eat breakfast or regular meals throughout the day, so when asked to change their eating habits and improve their nutrition, I saw so many improvements,” she says.
After seeing how healthy nutrition helped many addicts, DesMaisons founded Radiant Recovery®, a free online community dedicated to healing unbalanced sugar sensitivity. Her work is based on the premise that some people are predisposed to addiction. “This group of people has a type of brain and body chemistry that makes them more vulnerable to addictive substances and behaviors, and they’ll be very drawn to sugar way before they discover alcohol because sugar creates the same biochemical response that alcohol does in the brain,” she says.
Your body and brain on sugar
Sugar is a simple carbohydrate that is found naturally in fruits, vegetables and dairy products, as well as added to many foods. All carbohydrates are converted into glucose during digestion, and glucose is the form of sugar that is used in the body for energy.
While natural sugars aren’t harmful to eat for healthy people, the World Health Organization recommends that “added sugar” make up no more than 10 percent of our daily intake. “Right now the average American is consuming much more than that - about 22 teaspoons of added sugar a day,” says Avena. “Sugar in and of itself isn’t bad, but we as a society have lost our ability to accurately control how much we’re consuming. Many of the foods we consume that we think are healthy, are actually packed with sugar. Things like pasta sauce, BBQ sauce, and sausage, you don’t necessarily associate with sugar, but often contain added sugar.”
So what’s the real deal with sugar when it enters your body? Cameron Wells, MPH, RD, dietitian at the Physicians Committee for Responsible Medicine, says when you eat sugar it immediately turns into glucose, gets into your blood stream and triggers the release of insulin.
“It’s then pulled into all your muscles and cells so the sugar can be used for energy. When you get too much sugar, you’re going to have that real intense spike in blood sugar level, which is associated with that addictive cycle because you have that sugar high and a lot energy for a while and then you quickly crash once that insulin kicks in and your blood sugar level comes back down. This is when people tend to go back for more so they can get that rush of energy again,” Wells explains.
Your brain is instantly affected too. “When sugar touches your tongue, you trigger the release of opioids in your brain. These opioids are like natural pain killers or endorphins. They trigger the release of dopamine, the chemical that’s responsible for feelings of pleasure,” explains Wells. “Your body typically remembers that experience so when you eat that sugary food again, you have that fond memory and are more apt to go back for more. Alcohol, tobacco, and marijuana all play on the same pleasure center of the brain too.”
Who’s at risk for sugar addiction?
One theory that exists is that anyone can become dependent on sugar based on the notion that the more sugar you eat, the more you alter the dopamine receptors in the brain, leading to the desire to want more sugar. While this may need further research, DesMaisons says that research has shown that genetically certain people have lower levels of beta endorphin and this makes them more vulnerable to alcoholism. “People with lower levels of beta endorphin get a more intense reaction when they consume sugar and alcohol because they have more receptors opened up, so they get a bigger hit, and a bigger withdrawal when all the extra receptors empty out,” she says.
DesMaisons adds that people who are not predisposed to addiction can resist sugar more easily. "They can eat half a cookie, leave it on the counter, and walk away. But people who are vulnerable to the addictive qualities of sugar will eat the sugar and want more. Plus, they can’t imagine a life without sweet stuff. The difference between a sweet tooth and sugar addict is that the sweet tooth can adjust her sugar intake when faced with health issues.”
While Avena agrees that certain people are more prone to develop addiction, she says that research indicates people who are diagnosed with binge eating disorder have the highest comorbidity of also having food addiction. “Up to 50 percent of people who have binge eating disorder will meet the criteria for having a food addiction as well. But research also shows that food addiction is among people who are obese, who have had bariatric surgery, and of people who are normal weight, so it seems it can be seen across all types of people,” she adds.
Ways to cut sugar out
To curb your sugar cravings, DesMaisons and Wells say first start by eating a nutritious breakfast. “I have many people tell me that they’re miserable with their sugar intake, but they’re having a cappuccino for breakfast. Starting the day off with a sugar-loaded drink isn’t the way to go,” DesMaisons says. “Once you have eating breakfast down, then move on to eating lunch and dinner daily too. Seems simple, but many people with an addictive nature don’t eat regular meals throughout the day. Giving your brain the nutrients it needs to heal itself is the most important step to recovery.”
Fill up on fiber too, suggest Wells and Avena, because it helps to stabilize your blood sugar. Healthy foods that contain fiber include fruits, vegetables, beans, and legumes.
DesMaisons says apples and bananas are great go-to fruits. “When people are in early recovery, I suggest that they have 3 bananas a day because bananas are high in fruit sugar and help your brain calm down yet they don’t give you a huge spike like candy would,” DesMaisons says. She also suggests eating a small potato before bed. “Potatoes raise the level of serotonin in your brain, which makes you sleep better. If you increase serotonin in your brain you’re also less depressed and able to resist temptations. In fact, alcoholics have lower levels of serotonin in their brains, which is why it’s hard for them to say no.”
Sticking to low glycemic index (GI) foods is a great way to keep blood sugar levels under control, notes Wells. “Look up the foods so you can see their values based on the GI number. While there are rules of thumb, foods are broken down differently. What you may think is a low GI food, may be high. For instance, white and wheat breads have similar GIs, but people don’t generally think that since we’ve been ingrained to think that wheat is healthier. In terms of bread, pumpernickel is typically your best choice. Also, white and wheat pasta have similar GI values and they’re both lower than bread,” she says. While fruit is a healthy choice, Wells says pineapple and watermelon are higher on the GI index.
In her book, Why Diets Fail, Avena suggests that people identify why they consume sugary foods and figure out what healthier alternatives they can replace them with. “For instance, if you’re a big soda drinker, ask yourself what is it about the soda you like? If you like drinking something bubbling, maybe switch to seltzer water. If it’s the caffeine, maybe switch to black coffee. And if it is just the sweet taste, eat fruit every time the craving arises,” she notes.
Not a laughing matter
While it may seem far-fetched to compare over-eating sugar to problem drinking or drug use, DesMaisons says we should take note. “People who laugh off sugar addiction do so because they’re not addicted,” she says. “I work with people all over the world who are addicted to sugar and don’t know what to do about it. There is a lot of pain associated with this addiction. It’s real.”
Avena says the more research that’s done, the more history may repeat itself. “If you look back to the 1960s, the same sentiments were thought about tobacco use. People didn’t think tobacco was addictive or bad for you, and there weren’t regulations on its use. Now, we know tobacco is clearly addictive and can cause cancer, and we have regulations related to its use,” she says. “We need to do more research on sugar to truly characterize it and understand it so we can address it as a society. But the research that already exists certainly leans toward limiting sugar as much as possible.”
That’s easy enough to digest.