The sweet lowdown: Is sugar the world’s most ubiquitous drug?
The hit. The rush. The crash. The need for another fix. This roller coaster-like experience is one we usually associate with an addictive drug, like heroin or cocaine. But studies have shown that we experience the same range of physiological responses when we consume sugar. Except that this white stuff is legal.
Like Homer Simpson with a box of donuts, sugar addicts scarf sweetened goods — which we now know transcend just desserts to include kitchen staples like tomato sauce, salad dressing, breads and cereals, among other items — greedily hunting down their euphoric effects.
“When one consumes excessive amounts of sugar, it leads to changes in gene expression for opioids that are similar to what you would see when someone is dependent on a drug like morphine,” says Nicole Avena, assistant professor at Icahn School of Medicine at Mount Sinai and author of Why Diets Fail (Because You’re Addicted to Sugar).
In 2008, Avena co-authored an animal-based study on sugar dependence by analyzing four components of addiction: bingeing, withdrawal, craving and cross-sensitization. The behaviours that resulted from sugar consumption were then related to the neurochemical changes that happen in the brain with addictive drugs.
Upon consumption, sugar sends a message to the brain that triggers its reward system, which is the same system that surges when we do intensely pleasurable things like have sex or do drugs. Dopamine, which is the main chemical in the reward system, is sent into overdrive every time an addictive substance is consumed, thus causing the person to seek that “high” over and over again.
In a TED-Ed Original, How sugar affects the brain, Avena explains that dopamine is naturally released when we eat. But after eating the same food repeatedly, it starts to level out and we no longer experience the same “high” from eating it. (Apparently, you can get sick of pizza.) This is an evolutionary response to varying our diet to ensure we get a range of vitamins and minerals. However, with over-consumption of sugar, dopamine levels never even out. We simply don’t get sick of eating it.
The subjects of Avena’s study also experienced the classic symptoms of withdrawal normally associated with substance abuse.
“Excessive use of sugar can produce a withdrawal-like state that is characterized by tremors, shakes, anxiety and bodily changes that are similar to opiate withdrawal,” she says. “They’re all characteristics of addiction that have been shown with sugar.”
That’s something that Doreen can attest to. She went to Food Addicts Anonymous 27 years ago (she can’t share her last name as anonymity is an integral part of the program) and says she’s still relying on the tactics they taught her today.
“When I entered the program, the thought of not eating sugar was horrific,” she recalls. “But they said to me, ‘Can you do it for just one day?’ And I took it one day at a time, and still do that today.”
She also describes what she felt as she withdrew from sugar.
“Mood swings, back aches, flu-like symptoms, crying,” she says. “Everyone is a little different, but it’s an addiction and it will come with withdrawal.”
A not-so-sweet past
When we look at history, it comes as little surprise that there are parallels between sugar and other addictive substances. Sugar arrived on European shores from the tropics in the 16th century along with a spate of other now notorious delights, like coffee, chocolate, rum and tobacco.
Unfortunately, neither the dopamine response nor the forbidden nature of sugar are the only reasons we crave the sweet stuff. It turns out, we’re actually hardwired to want it.
“The T1R on the tongue that detects sweetness is the most evolutionary receptor we have,” says Robert Lustig, a professor of pediatrics at the University of California San Francisco and author of the upcoming book The Hacking of the American Mind: Inside the sugar-coated plot to confuse pleasure with happiness (September 2017).
Everyone is born with five taste receptors on the tongue — sweet, salty, sour, bitter and umami (or savoury) — but our propensity for sweet dates back to ancestral times.
“Nature likes to experiment with mutation, but this taste was conserved all the way through virtually every animal and all humans,” he says. “It’s because sweet was an evolutionary signal that any given foodstuff in the wild was safe to eat. There’s nothing that tastes sweet that’s also acutely poisonous.”
But experts would argue that sugar is, in itself, a poison. The most recent Canadian statistics indicate that 20.2 per cent of adults (approximately 5.3 million people) classified as obese in 2014.
And the addiction isn’t just outwardly apparent, either. People blessed with a fast metabolism might be able to eat as much sugar as they want, but that doesn’t mean it isn’t wrecking havoc on their liver.
“Sugar is like alcohol, except it doesn’t give you the acute effects drinking does,” Lustig says.
Alcohol is borne from the fermentation of sugar; that’s what wine is. Except with alcohol, the yeast that’s in it takes the first step in metabolizing it, whereas, with sugar, our bodies take that first step. When our systems receive a rush of sugar, it can’t be metabolized, so it passes through the liver and becomes fat.
That liver fat is the starting point of heart disease, Type 2 diabetes and tooth decay, and has been shown to have links to cancer and dementia.
“Virtually all the chronic diseases we are dying from are driven by sugar,” Lustig says.
The sugar cover-up
So, how did we become over-sweetened masses? It all started in the 1960s when sugar interest groups messed around with scientific studies.
The New York Times ran an exposé in September detailing how the sugar industry paid off scientists in the 1960s to downplay sugar’s effects on heart disease and instead single out saturated fat as the villain.
The documents were published in JAMA Internal Medicine and show how the Sugar Research Foundation paid three Harvard scientists $6,500 in 1965 (roughly $49,000 today) to conduct research studies on the effects of sugar and fat on heart disease. The foundation’s members then sifted through the studies to find the ones that indicated fat was the greatest health offender and published those in the New England Journal of Medicine.
“They were able to derail the discussion about sugar for decades,” Stanton Glantz, a professor of medicine at U.C.S.F. and an author of the JAMA Internal Medicine paper, said to The New York Times.
To add fuel to the fire, in 1977, the USDA released its first dietary guidelines pointing an accusatory finger at saturated and animal fats. The only problem was that people wouldn’t (or couldn’t) distinguish between healthy fats and saturated fats, so all fats were demonized. It gave birth to the low-fat movement, which opened the floodgates for added sugar.
“When you take the fat out of food, it tastes terrible,” Lustig says. “So they had to make it more palatable with added sugar.”
Like any addictive substance, quitting sugar requires a cold turkey approach, but the rapidity of positive effects might make the task a little easier.
In a 2015 study published in the journal Obesity, Lustig culled a group of 43 kids with metabolic syndrome (the precursor to diabetes) and replaced all the added sugar in their diets with starch. Pastries and teriyaki mains were replaced with bagels and turkey hot dogs, for example. (It’s important to note that the goal was not weight loss, but to measure the physiological changes from cutting out added sugar.)
After 10 days on this new diet, all participants showed improvements in their metabolic rates, including reduced blood pressure, lactate and triglyceride levels. While most participants lost weight, the study’s most interesting finding might just be that in those who did not lose weight, the metabolic changes were still consistent.
The inevitable takeaway is that sugar is bad for you.
Like fats, however, some sugar is fine. We know fruit is loaded with sugar, but because it has such a high fibre content, the fibre acts as a barrier in the intestine and prevents the body from absorbing the sugar. That’s also why juice is the worst way to ensure you’re meeting your daily fruit intake — once you take the fibre out, all you’re left with is sugar.
It’s hard to avoid added sugar, especially considering that two-thirds of all packaged foods in Canada contain added sugar, but there are some supermarket tactics you can employ.
“It’s like what health experts have been saying for a long time: shop the perimeter of the supermarket and take time to read labels,” says Quinn Hand, a naturopathic doctor and founder of Q Wellness.
It’s also important to educate yourself on the many aliases sugar goes by.
“The hard part is that people don’t know when they read ‘maltodextrin,’ it’s just another name for sugar,” she says.
She recognizes that sugar has quietly seeped its way into unassuming foods, like canned tomatoes, but she says that the first step in trying to reduce you and your family’s added sugar intake is to prepare things from scratch.
“Education has to come in especially for breakfast foods, because cereal has a lot of added sugar,” she says. “When we talk about breakfast, we want to talk about blood sugar sustaining foods, like eggs or steel-cut oats. High carbohydrate and sugary cereals are not beneficial.”
Kicking sugar is also a question of rethinking its place in modern life. As with most things, it’s about going back to basics.
“Once upon a time, sugar was a condiment that you used for coffee and tea,” Lustig says. “Now it’s a diet staple. We need to go back to a previous way of thinking. Bring back the concept of ‘one lump or two?’ and that will help keep our consumption under the disease-causing threshold.”
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