Sugar: A Sweet Addiction?

We can define addictions as habits involving dangerous behaviors or substance use that are either impossible or very difficult to stop. This results from the degree of psychological and/or physiological dependence they produce . According to the World Health Organization (WHO) , addictions make it difficult for a person to modify the amount and intensity of their substance use, thus preventing them from stopping.

Traditional addiction research has focused on drugs of abuse, such as morphine, cocaine, nicotine, and alcohol. However, modern studies now address a variety of "addictions" to non-drug-related entities, such as gambling, sex, and even food; hence the question: is sugar addictive?

The WHO recommends 25 grams of sugar per day, setting a maximum limit of 50 grams for adults. However, consumption in Western societies far exceeds this limit, reaching 70 grams per person per day in Spain and 126.4 grams in the United States. There are reasons that could explain these excesses, in addition to its pleasant sweet taste.

When we experience something we consider meaningful, the brain rewards us with a feeling of enjoyment, happiness, and well-being. This can happen as a result of natural stimuli, such as sex, socializing, or learning something new. Both natural and artificial stimuli, such as drugs, activate the brain's reward system, where neurotransmitters like dopamine and opioids are released.

A study conducted on pigs and published in Scientific Reports reveals a reduction in dopaminergic and opioid receptors, meaning that the subject must ingest a larger quantity of the substance that triggers the pleasure response to achieve the same level of satisfaction experienced after the first dose. According to the authors, the study's results suggest that sucrose (sugar) acts as a kind of drug of abuse, as it affects the brain's reward mechanisms in a similar way.

When referring to drug use, addiction is known as substance use disorder (SUD) and is considered a “brain disease characterized by the compulsive use of substances despite harmful consequences.” Experts use a diagnostic manual that, in its section on substance use, incorporates eleven criteria for the diagnosis of addiction: 1. Using a larger amount and for a longer period than intended; 2. Strong craving for the substance; 3. Prolonged use; 4. Repeated attempts to quit and/or control use; 5. Social/interpersonal problems related to use; 6. Neglect of primary responsibilities; 7. Neglect of other activities; 8. Continued use despite risk; 9. Physical/psychological problems related to use; 10. Development of tolerance; 11. Signs of withdrawal. A patient must meet at least two of these criteria to be considered addicted, or a substance must elicit at least two of these symptoms to be considered addictive.

Studies conducted with rats demonstrate strong evidence of sugar addiction. In the model used, five of the eleven diagnostic criteria for substance use were met, specifically: use of larger quantities and for longer periods than intended, strong craving for the substance, continued use despite risks, tolerance, and withdrawal.

It is not surprising that natural behaviors (eating) and addictive drugs likely share the same neural systems. The search for nutritious food in times of scarcity, such as in prehistory, must have established addictive mechanisms, since upon finding it, consumption was at its maximum, allowing for survival during prolonged periods of starvation. These addictive mechanisms are not only useful in eating behavior; it has been observed that cocaine use by Andean indigenous people, as well as caffeine use by night shift workers, are also necessary for survival, as they improve physical performance in two challenging situations.

From an evolutionary perspective, we should consider addiction as a normal trait that allowed humans to survive in primitive conditions when food was scarce. As we evolved culturally, the neural circuits involved in addictive behaviors became dysfunctional and, instead of helping us survive, are actually compromising our health.

More important than whether sugar is addictive or not are the counterproductive effects of a high intake of processed sugars, as these effects extend far beyond simple tooth decay. While infectious diseases are the leading cause of death in developing countries, in developed countries the vast majority of deaths are due to non-communicable diseases, most of which are exacerbated by lifestyle and diet. These include cardiovascular diseases (stroke, myocardial infarction, among others) and metabolic diseases, such as diabetes mellitus, obesity, arteriosclerosis, hyperlipidemia, and hypertension.

Unlike drugs of abuse, sugar is necessary for our bodies to function; however, consuming it in excess can be harmful to our health. Limiting our intake can help us stay within safe limits. We know of foods that explicitly contain sugars, but there are others where the sugar isn't so obvious; these are the foods to which the food industry adds sugars to make them more appealing. It's important to read labels before consuming, focus on preparing healthy meals, and limit our intake of foods containing added sweeteners to enjoy better health.

There is a subtlety to food addiction in that a significant majority of people who meet the criteria for addiction may not be aware of it, probably because it is not widely accepted as a social norm. Furthermore, the term addiction carries an associated cultural stigma.

Do you have problems with sugar consumption? There are indicators that can alert us to whether we are addicted or not.

• Consuming sugary products compulsively, on a daily basis .
• Plan your candy shopping frequently.
• Replacing healthier foods with sweets, such as juices instead of fruit.

When you want to consume sugars in excess, think about the negative effects on your health and look for another reward system.

Ramona Ávila Núñez, PhD

References

Winterdahl, M., Noer, O., Orlowski, D., Schacht, A.C., Jakobsen, S., Alstrup, A.K., et al . (2019). Sucrose intake lowers μ-opioid and dopamine D2/3 receptor availability in porcine brain . Scientific reports , 9(1), 1-11.

David A. Wiss , Nicole Avena , and Pedro Rada . Sugar Addiction: From Evolution to Revolution (2018 )Front Psychiatry 9: 545

Rada, Pedro, Avena, Nicole M, & Hoebel, Bartley G. (2005). Sugar addiction: myth or reality? Venezuelan Journal of Endocrinology and Metabolism , 3 (2), 02-12. http://ve.scielo.org/scielo.php?script=sci_arttext&pid=S1690-31102005000200002&lng=es&tlng=es