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.
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.
Franziska Spritzler, RD, CDE