Sugar and Food Addiction 

The following is a paper I recently submitted on food addiction, as part of a course of study in Biology. I present it here in the simple hope that it might provide a useful and thought provoking framework to guide anyone who thinks that this might be an issue for themselves or a loved one. And also for anyone with an interest in the subject. 

Depending on your response, if we find that many of us wish to explore the area further, we can open up a forum to share more. It is an area of personal interest for me and in the past, I have danced sometimes in the middle, sometimes on the outside of the very issue myself. 

Therefore, may the following serve as a helpful resource for increasing our awareness on this sometimes sensitive and controversial issue. In order that we feel empowered and emboldened to make healthy choices for ourselves and our children. Most of all, may we respond lovingly wherever we feel that this particular challenge may touch our lives. 

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Food Addiction

Justification

The theme of food addiction as a contemporary issue, coupled with the author’s premise that this is a common, rather than a rare problem, may seem unpalatable. The word “addict” holds extreme and negative connotations. However food addiction is worthy of exploration because in exploring the relationship between brain/body chemistry and sugar, information related to questions about issues such as obesity and addiction in general, could also be gleaned.

The essay draws from the wide body of research available on the intrinsic components of food addiction. Facilitated by the pioneering work of Kathleen DesMaisons PhD who revolutionised the field of chemical dependency with her research in addictive nutrition. (Please see attached bibliography). Kumar and Clark’s Clinical Medicine – another source used in this essay, is an internationally recognised medical textbook. It is written by an International Advisory Panel of experts from around the world and regularly updated.

When referring to food addiction, the essay is particularly concerned with the issue of excessive consumption of refined/sugary foods, and simple carbohydrates which the author asserts can cause dependency in a pattern similar to that of opiate drugs. For ease of reference the aforementioned products are referred to as “food”. There is insufficient scope within this essay to argue the case whether or not highly processed products actually merit the use of this definition!

In addition to the areas already mentioned, food addiction has evolved out of the modern UK diet and its’ love affair with sugar. For example, traditionally, fructose was not present in the human diet in the quantities of today. In particular, high fructose corn syrup (derived from the hydrolysis of starch, synthesised from corn) is often integrated into everyday foods that are widely eaten. Postprandial fructose corn syrup travels to the liver and is then rapidly metabolised. The products from this process vary: glucose, glycogen, lactic acid or fat depending on the individuals’ ability to process it. Could this highly processed sugar have a role in food addiction and obesity?

Introduction 


The following study also helps illustrate part of the authors premise: That excess sugar in the modern UK diet has become the norm and is part of the issue of food addiction. The consumer group, Which? found that out of 100 leading cereal brands, 31 contained more than four teaspoons of sugar per serving. It also concluded that 59% offered “poor nutrition” (The Sunday Times 03/05/09). The study found that (with same size servings), Tesco’s Dark Chocolate Fudge Brownie Ice Cream contained 11.6 grammes of sugar. A bowl of Morrisons Choco Crackles cereal (marketed at children) contained 15.35 grammes of sugar per serving.

In light of these findings it may therefore be of concern that a (2001) DEFRA study demonstrated that 74% of the UK daily food intake was based on cereals and cereal products, with inadequate levels of complex carbohydrates. (Barasi, Mary E. Human Nutrition (2003)).

In a normal human reaction, when carbohydrates are consumed, insulin is secreted by beta cells in the islets of Langerhans in the pancreas, proportionate to blood glucose levels. The release of insulin has the effect (amongst other actions) of increasing the rate of cellular respiration. In particular the liver cells, adipose and muscle cells increase their uptake of glucose for immediate use or storage.  In a food addict/sugar sensitive individual, upon eating (the preferred) nutritionally poor food (for example a donut), blood glucose levels rise more rapidly than normal. This causes a systematic heightened physiological response in the endocrine and nervous systems. An excessive amount of insulin is released to compensate for the blood sugar spike.

Blood glucose levels then plummet, as inordinately as they rose, causing the sensation of a sharp dip in energy levels. At this point in the cycle, another sugary food may be an attractive option. And here there is the risk that hypoglycaemia may be self diagnosed incorrectly. In hypoglycaemia The Oxford Medical dictionary states that: “A blood glucose deficiency is linked with insulin overdose (particularly in diabetics) and an insufficient intake of carbohydrates”. Therefore following on from the point (above) of the energy lull, eating again would restore normality. For the sugar addict however, eating again at this juncture would likely cause another exaggerated physiological response. Therefore sugar sensitivity and hypoglycaemia are not the same. However research indicates that the terms sugar/carbohydrate sensitive and sugar/carbohydrate addict are virtually interchangeable because one leads to the other.

Food addiction is often linked to malnutrition because of the inherent requirement in the dysfunction, for an almost constant flow of sugar. Above what the body requires for cellular maintenance. Hence processed carbohydrates, which are metabolised by the body relatively quickly, are likely to make up the bulk of the diet.

During the manufacture of processed high starch foods, starch granules are disrupted. This results in the release of amylose which is easily broken down by digestive enzymes. To the sugar addict this translates as a more rapid sugar “high”. By contrast, in cellulose (present in a healthier option such as a carrot) this is not the case. Comparison of chemical structure may illustrate one reason why a sugar addict will rarely crave a food such as this. Cellulose is a tough structural polysaccharide, formed from beta glucose units linked by 1-4 glycosidic bonds. Because the hydroxyl groups alternate on either side of the molecule, its tough structure is not easily hydrolysed. Of course humans do not produce cellulase. Hence there is an absence of the heightened blood glucose rise the food addict seeks. Starch for example, (formed from mainly 1-4 glycosidic bonded alpha glucose units) is more easily hydrolysed and broken down into glucose for respiration.
The blood sugar ‘spike’ may be experienced by the food addict as a broad range of feelings. From quiet contentment – especially if in addition, the food has comforting connotations. For example; mince pies which may also remind the addict of pleasant Christmas memories. This would light up neural pathways in the hippocampus.One area in the brain connected with long term memory - to feelings of euphoria. This would depend on various factors including how much of the food had been eaten. Seductive sensations like euphoria occur due to the release of opioids in the brain. Opioids are endorphins; Peptide neurotransmitters linked with pleasure and sex. A neurotransmitter is a chemical communicator in the nerve pathways of the brain.

The starting point for the food addicts’ euphoria is the stimulus which triggers a nerve impulse. The author asserts that sugar is the chemical stimulant. Dr. Joseph Mercola also makes this connection. In his book; The No Grain Diet, Mercola refers to a sugar addict patient. He explains that the patient’s cravings are effectively a cellular cry to restore the sugar high which has become the norm. Dr. Mercola adds that emotions are on edge when they are no longer pacified by the neurotransmitter serotonin, released by grain consumption.

The chemical (sugar) stimulus generates an action potential. This is then propagated as a nerve impulse. It reaches the presynaptic membrane and depolarises the membrane. This depolarisation triggers the opening of special gated ion channels whereby the neurotransmitter (previously stored in the synaptic vesicles of the axon) diffuses across the synapse (a gap between cells of about 20 nm) to its awaiting neuroreceptor. Neuroreceptors are protein molecules on the post synaptic cell membrane.   Neurotransmitters are chemical messengers. In food addiction, of particular interest are neurotransmitters beta endorphin and serotonin. Serotonin is possibly the most important because although it is only released by a small number of neurons in the brain, each of these neurons connect to thousands of others. Therefore serotonin has great influence over many complex functions in the brain.  Serotonin plays a part in brain regulatory processes such as; sleep, mood, appetite and pain. The neurons in the Raphe nuclei (The Serotonin Pathway) produce Serotonin. Raphe nuclei neurons suffuse serotonin over the entire brain and spinal cord. Receptors for this (and related) transmitters become sensitized when addiction develops. The food addict becomes accustomed to the soothing and pleasurable effects of neurotransmitters such as beta endorphin, dopamine and serotonin.  Failure to maintain the unnaturally elevated neurotransmitter levels leads the food addict to become anxious with the strong need to eat sugary or high fat foods again. In some individuals high fat, sugar loaded foods (such as chocolate) have a similar effect. Others prefer to use sugars from sweets and simple carbohydrates. 

The anxiety referred to above has been studied in sugar addicted rats. Dr. Jade Kathleen explains in The Journal of Naturopathic Insights, that these rats were found to demonstrate withdrawal symptoms including, teeth chattering, tremors and anxiety. “The rats binged on sugar as soon as it became available again”.

In the same article Dr. Jade also offers other possible causes for food addiction, suggesting links with poor blood sugar regulation, stress and lack of sleep.

In a report initially published in the New Scientist, Neal Barnard holds that food addiction is in part a genetically inherited dysfunction. Barnard argues that there are a reduced number of neuroreceptors for dopamine. Barnard also defines addiction in any form, as the inability to refrain from repeating a behaviour (in this context: the eating of simple carbohydrates/sugar) despite its harmful effects. And what are these harmful effects? Dr. Mercola makes the case that grains not fats are the true authors of weight gain. Mercola does not rule out the value of complex carbohydrates (after a period of recovery from sugar addiction). But does however point to research integrated in his book; that consumed unchecked; grains and sugars lead to obesity, insulin resistance seen in pre diabetic conditions and ultimately to heart disease, cancer and stroke.
Therefore once the addiction is established, Mercola explains that exhortations to moderate food misuse are akin to advising the heroin (an opiate) addict to reduce intake. Psychologist Richard Gross equates the powerful chemical reactions that occur during important survival behaviours with heroine use. (An example might be sexual reproduction). During sexual intercourse endorphins are released into the fluid that suffuses neurones, producing intense pleasure. In the heroin user the same process occurs with greater intensity. “Regular use of opiates overload endorphin sites in the brain and the brain stops producing its own endorphins”. (Snyder, 1977). In food addiction it is striking therefore that similar neurochemistry is at work.

From the perspective of marketing advertisers it could therefore be argued that using sexual messages to boost sales of certain food products is justifiable, even logical. Despite the negative effects on the UK population attendant with overconsumption. Indeed the parameters of acceptability shift with changing social consciousness and with time. For example, in the 1890’s the soft drink Coco Cola’s ingredients included cocaine (Plant, 1999). Cocaine is now an illegal Class A drug. 

In an article entitled; Enough is Enough, New Scientist contributor Maia Szalavitz opposes the author’s theory. Szalavitz asserts that comparing food addiction to recreational drug addiction is an oversimplification of a complex and little understood issue.

However Szalavitz does concur that the same neural circuitry is operating in food addiction as in drug addiction. Szalavitz believes that it is appropriate that scientists earmark certain foods as more likely to induce cravings.

What biologists are doing to try and solve the problem

Biologists are tackling the issue of food addiction at a number of levels. Primarily the focus could be narrowed down to: Raising awareness of the issue, research, treatment and prevention. For example, at the IslandWood residential environmental education center in Seattle, scientists and researchers convened at a 2009 conference; ‘Obesity and Food
addiction’ and shared research findings which strongly support the scientific theory regarding the connection between highly processed foods, the brain’s dopamine pathway and addiction. Knowledge sharing across various disciplines improves translation, i.e. the conversion of research findings to actual patient care. Improvements in PET scanning and fMRI scanning technology have improved the agility with which scientists can monitor fluctuations in the neurochemistry at work during episodes of binging for example. Such information could help patients modify their behaviour. Geneticists are also uncovering genes which can predispose certain individuals to addictive behaviours such as overeating. At the Alcohol Research Center Semel Institute for Neuroscience & Human Behaviour at the UCLA School of Medicine, Dr. Nobel and colleagues were some of the first scientists to discover the link between the DRD2 receptor gene and alcoholism. This team later discovered that the DRD2 gene is involved in substance abuse disorders including cocaine, heroin, nicotine and food addiction.

At the clinical level, treatment programs are centred around 12 step programs, psychotherapy and counselling. Evidence via data regarding the success of psychotherapeutic interventions in the field is primarily qualitative rather than quantitative. For example, Mark M Gold, M.D. is from the University of Florida College of Medicine’s Brain Institute and Chairman of the Department of Psychiatry. Gold’s research brought to light the effectiveness of the drug clonidine as a safe option for reversing opiate withdrawal symptoms, though itself not an opiate. However later research uncovered that clonidine was only effective for the withdrawal stage and not a long term solution.

How appropriate is the solution

Counselling is available on the NHS for patients in most parts of the country; however in many places there may be a significant waiting list to receive treatment and usually treatment is provided on a short term basis only. Therefore this approach is limited in its effectiveness. Private Cognitive behaviour therapy and counselling may be prohibitive due to the costs involved, however long term ‘talk therapy’ may offer the most realistic option for patients wishing to regain control over food addiction. 12 step meetings are perhaps the most economically viable because they are free and offer the support of other recovering addicts who may have similar shared experiences. 

Implications of solution to problem / Benefits and risks of solution

The option of using brain scanning to provide helpful guidance to the patient in recovery and the drug clonidine are impractical due to being costly and (clonidine) of limited use as earlier discussed. 12 step meetings are not necessarily available where need is greatest. However there are no restrictions on anyone wishing to set up a 12 step support group. However, one of the fundamental principles of 12 step meetings is that they are anonymous. This principle ensures the kind of honest disclosure within the safety of the group that is associated with successful recovery. Anyone founding a new group may have to forfeit this privacy, which could negatively impact on their own recovery from food addiction.     

Alternative solution

Individual cognitive behavioural therapy may be more effective than interpersonal therapy and drug treatment. However, SSRI’s such as fluoxetine hydrochloride (Prozac), even in the absence of depression, are an alternative solution because improving the mood of the patient could help modify behaviour leading to addictive eating patterns. As an alternative to SSRI's (anti depressants), could be Serotone 5HTP supplements, which can be used, with a few reported side effects - The amino acid 5HTP is the precursor to serotonin. Serotonin, is a the key neurotransmitter which plays a vital role in regulating mood, sleep and metabolism. 




 

Website References

Absolute Astronomy (2009) Neurones http://www.absoluteastronomy.com/topics/Sensory_neuron#encyclopedia [Accessed 29/1/2011]

Biology Mad (2009) Nervous System http://www.biologymad.com/NervousSystem/synapses.htm [Accessed 29/1/2011]

British Medical Journal(2003), B. Neal. Compulsive Eating www.bmj.com  [Accessed 13/2/2011].

British Medical Journal(2003), Szalavitz, M. Enough is Enough

Originally published in New Scientist (February 2003) www.bmj.com [Accessed online 13/2/2011]

Journal of naturopathic insights, J. Kathleen. Dr. (2006)When a sweet tooth becomes a real addiction, http://drkathleenjade.com/. [Accessed 13/2/2011]

The University of Utah (2009), author unknown, Beyond The Reward Pathwayhttp://learn.genetics.utah.edu/content/addiction/reward/pathways.html[Accessed 29/2/11]

Journal References

Shreeve, J. (2005) “Beyond the brain”, National Geographicvolume; March 2005, page # 2

 Bibliography

Barasi, M. E. (2003) Human Nutrition Second Edition, U.K. ArnoldPublishers

Des Maisons, K.PhD (2000) The sugar addict’s total recovery programmeU.K. Simon and Schuster UK Ltd.

Bibliography continued.

Gross,R. (2005) Psychology, the science of mind and behaviour, Fourth Edition, U.K. Hodder and Stoughton,

Kent, M. (2000) Advanced Biology, U.K.Oxford University Press

Kumar, P. Professor, Clark, M. Dr (2009) Clinical Medicine, U.S.A. Elsevier. 

From Lloyds Pharmacy magazine Oct 2011