Sugar. It's one of the most common substances we consume, often without even realizing it. Cookies, ice cream, candy, cake, and soda are obviously high in sugar, but ketchup, soy sauce, "light" yogurt and many other seemingly innocuous foods contain a fair amount as well. Food manufacturers love it because it's inexpensive, functions as a preservative, and greatly enhances taste.  These days refined sugar is accepted, expected, and readily available in our society. For some people, occasionally indulging in small quantities of sweetened foods may be harmless and enjoyable. But sugar appears to have a profoundly negative effect on many others, who find that even a modest amount can set off strong cravings for more, more, more.

This Sunday, October 30, the first Sugar Addiction Awareness Day will be held.  I can't think of a better time  for it than the day before Halloween, when the "holiday eating season" unofficially begins.  I'm writing this article as part of a National Blog-a-Thon on Sugar Addiction aimed at spreading awareness about this disorder.

For most of my adult life, I've always found it fairly easy  to eat small amounts of real sugar. For instance, I'll occasionally have one small square of a large chocolate bar or one bite of my husband's piece of cheesecake and feel completely satisfied. These treats provide less than five grams of carbohydrates and don't pose a major threat to my blood sugar control. While this works well for me, I am very sympathetic to people who can't do this. I'm speaking of the ones for whom "only one cookie"  is like "only one drink"  for an alcoholic -- virtually impossible. 

But is sugar actually an addictive substance, in the true sense of the word? Apparently, this is still the subject of debate among experts, namely psychologists, but certainly not for those who identify themselves as sugar addicts. Foods containing sugar have a very high reward value and supply a rapidly absorbed form of energy that provides a "boost"  many come to depend on. Sugar also activates endorphin receptor sites and  triggers dopamine release in the brain in the same way that morphine, cocaine,  and nicotine do. To be fair, lots of things can cause the release of dopamine, including exercise, spending  time with family and friends, listening to beautiful music, or viewing an exquisite piece of art -- basically anything pleasurable. But unlike these, sugar is an ingested substance that causes neurochemical changes within minutes of its consumption. (Interestingly, there is some evidence that sugar substitutes may have the same effect due to the brain being "tricked" by their sweet taste.)

The most frequently cited research on sugar addiction has been conducted on rats, who demonstrated binging/overeating behavior after being given a sugar-water solution 12 hours after fasting and withdrawal symptoms similar to that seen with opiates after going 24 hours without food following a period of high sugar intake. These are promising findings, but they do not prove nor disprove whether sugar can be "addictive" (per the universally accepted term) in small quantities when consumed with other foods. However, a brief online search reveals enough anecdotal evidence to strongly suggest that sugar addiction is very real and can have devastating consequences for one's health and happiness, including increased risk for obesity, metabolic syndrome, diabetes, and other disturbances in endocrine function.  Until the experts reach a consensus on whether  "sugar addiction" is a legitimate term, perhaps saying "sugar compulsion" would be better received. Or maybe not. But regardless of what we choose to call it, it's hard to argue with the idea that those who feel their sugar intake is out of control should avoid it completely rather than attempt to eat small amounts as part of an "everything in moderation" approach. 

If you or anyone you know and care about has an issue with sugar addiction/compulsion/excessive consumption, there are several resources that may be extremely helpful in terms of information and support. Please take some time to consider it on National Sugar Awareness Day, Sunday, October 30.  And have a safe and happy Halloween.


References

1. Colantuoni C, Rada P, Mc Carthy J, et al. Evidence that intermittent, excessive sugar intake causes endogenous opioid dependence. Obesity Research 2002. 10, 478-488
2. Avena NM, Rada P, and Hoebel BG. Evidence for sugar addiction: Behavioral and neurochemical effects of intermittent, excessive sugar intake. Neurosci Biobehav Rev 2008 32(1): 20-39
3. Stice, E., Yokum, S., Zald, D., and A. Dagher. Dopamine-based reward circuitry responsivity, genetics, and overeating. Curr Top Behav Neurosci 2011 6: 81–93.

While I can't deny the benefits of our ancestral diet, I'll be the first to admit that I don't follow every Paleo protocol (as described in Loren Cordain's The Paleo Diet and Robb Wolf's The Paleo Solution) .  I consider myself more Primal (based on Mark Sisson's Primal Blueprint) than Paleo. But recently I've been giving some thought to giving up dairy, if only temporarily. I currently eat organic Greek yogurt and cheese a few times a week, which is a lot less than than the two to three servings I used to have every day. I stopped drinking milk months ago. From everything I've read lately, going dairy-free makes sense for a lot of people, particularly those with autoimmune conditions like celiac disease, Type 1 diabetes, lupus, and Hashimoto's thyroiditis. I don't appear to have any of these, although I do have impaired blood sugar control,  hypothyroidism, and mild adrenal issues. Dairy has some strikes against it; however, it offers benefits as well.  I'm a list maker by nature,  so I decided to make a  pros vs. cons list (although not an exhaustive one) for organic  and/or raw dairy products:

Reasons to eliminate dairy:

1. Contains lectins:  Lectins are small  carbohydrate-binding proteins that protect plant and animal species but can damage our intestinal cell lining if consumed in excess.  Virtually all foods contain some lectins, and although not the largest offender (grains, legumes, and nuts have that honor), dairy has an appreciable amount of these potentially harmful substances.

2 It's insulinotropic: Milk's intended purpose is to promote growth in young mammals, and it's believed that   the protein casein is responsible for this effect.Because casein is present in all dairy products, consumption of even low-carbohydrate forms  such as cheese may cause insulin spikes which promote anabolism and weight gain.  (However, I have read blog posts from many who stopped drinking milk for 30 days or more and noticed no difference in weight or body composition).

3. Promotes a net acid load:  Our bodies desire homeostasis, or a balance in our blood between acid and alkaline of pH 7.3 to 7.4.  Acidic foods include meat, fish, eggs, and dairy;  fruits and vegetables are alkaline. On low-carb/Paleo diets, animal protein consumption is fairly high, so getting calcium from plant sources (leafy greens, seeds and nuts)  makes sense.

I won't go into the many issues I have with conventional dairy other than to say it contains residual hormones, antibiotics, and pesticides that can cause or aggravate many health problems.

On the other hand...

1. Contains conjugated linoleic acid (CLA): CLA has been credited with promoting weight loss, improving blood sugar control in persons with diabetes, lowering serum triglycerides, and decreasing cancer risk.  Dairy is one of the best sources of this fatty acid. The higher the fat content the better, particularly if it comes from  grass-fed cows.

2. Raw dairy is a whole food: While pasteurized, homogenized milk is technically a processed food, raw dairy exists in its natural state and has been consumed for thousands of years by certain nomadic and agrarian groups, many of whom have enjoyed long, healthy lives.

3. Excellent source of many nutrients: Milk products contains all the macronutrients (protein, carbohydrate, and fat)  and many micronutrients (all the vitamins, along with calcium, magnesium,  phosphorus, and potassium, to name a few) that are essential to health.

4. High satiety value:  Goat cheese, whole Greek yogurt, buffalo mozzarella, and cream cheese  just plain taste good!

So should we consume dairy or not?  There are some strong opinions on both sides of this debate, but I believe that it's a highly personal choice. I recommend going without dairy for at least 30 days (This is what I plan to do in the near future). If you have more energy, fewer allergies, improved skin quality, and feel better overall on a dairy-free diet, then certainly that's the best eating plan for you.  If you notice no difference in your symptoms, then eating dairy is probably fine and possibly beneficial. Again, we are all unique in our genetic and biochemical makeup; what works for one person may not work for another.  For optimal well-being, we need to be attuned to the state of our health and make dietary and other changes accordingly. By the way, acording to a recent post on Mark's Daily Apple, even Robb Wolf consumes some dairy and admits he follows a primal way of eating :)

References
1. Rabinowitz D, Merimee TJ, Maffezzoli R, Burgess JA. Patterns of hormonal release after glucose, protein, and glucose plus protein. Lancet 1966;2:454–6]
2. Josse A, Atkinson SA, Tarnopolsky MA, Phillips SM. Increased consumption of dairy foods and protein during diet- and exercise-induced weight loss promotes fat mass loss and lean mass gain in overweight and obese premenopausal women. J.Nutr September 1, 2011 vol. 141 no. 9 1626-1634
3. Cesano A, Visonneau S, Scimeca JA, et al. Opposite effects of linoleic acid and conjugated linoleic acid on human prostatic cancer in SCID mice. Anticancer Res 1998;18:1429-34.