‘Pie hole’, colloquial for one’s mouth, is believed to have evolved in the USA in the 1980s from the British expression ‘cake hole’ (coined in the mid 20th century). Pie hole refers to a mouth, as in: Shut your pie hole or, in this case: Put less in your pie hole.

Wednesday, August 16, 2017

4 Things to Wrap Your Sugar-Addicted Brain Around

You may have seen the memes floating around about sugar being addictive, don't worry if you haven't, I have one below! Although the thought of sugar addiction isn't new, it is, however, a gross oversimplification and misunderstanding of human biology and neurobiology. Humans are complicated, and science helps us appreciate just how complex the human body, brain, and psychology are.

Let's chow down and break down the science in relation to sugar and addiction.

First of all, addiction to a substance requires diagnosis by a certified professional using a standard set of diagnostic criteria outlined by the American Psychiatric Association in the Diagnostic and Statistical Manual of Mental Disorders (the DSM-IV). That's a mouthful, and possibly a risky opening paragraph... If you're still with me, thanks, it gets better.

Here are a few sweet spoonfuls of science to swallow:
  1. Neural reward pathways light up in response to eating... As they do in response to sex, drugs, and a good workout
    • It is actually the act, the behaviour of eating that lights up these pathways, not a substance (eg: sugar)
    • So no, you cannot extrapolate and say that sugar lights up the same pathways as drugs, and therefore sugar is addictive. Again, it's the act of eating a food (not a specific nutrient) that lights up the pathway, and as you'll read in #3 below, addiction and dependence elicit a number of symptoms upon withdrawal that do not occur with sugar
  2. Addiction is a highly complex chronic disease involving brain reward, motivation, memory, and related circuitry, as well as neurochemistry dysfunction... The American Society of Addiction Medicine says so
    • If addiction were a person, its relationship status would be: it's complicated
  3. Opiate withdrawal syndrome in relation to sudden opiate abstinence involves symptoms including hot and cold flashes, nausea, diarrhea, anxiety, restlessness, insomnia.... and then several others you've probably never heard of, so have fun google-ing these: piloerection, diaphoresis, myalgia, arthralgia, emesis, dysphoria, lacrimation, tachypnea, tachycardia, rhinorrhea, and hypertension
    • These withdrawal symptoms are similar for addictions to alcohol, stimulants, and sedatives... But not sugar, you dig?
  4. People often report "cravings" for foods (specifically, kinds of foods that are highly delicious, like chocolate, sweet desserts, or fried food)
    • BUT these people rarely limit their diets to specific nutrients or substances (eg: only eating sugar or fat)
    • AND these cravings are not as intense, frequent, and/or persistent in duration, unlike drug cravings
    • FURTHER, people restricting their intake of desirable foods (eg: chocolate) makes the forbidden food (eg: chocolate) ever so preoccupying. This is often interpreted as a craving and therefore an addiction, but really, collectively it may very well be part of normal eating behaviour. Basically, don't overthink it and make a mountain out of a molehill
Perhaps you're rethinking the sugar addiction thing a little... Maybe? In reality, your addiction might be to social media and sensationalist soundbites.

Back to point #1 about reward centers lighting up when eating, to reiterate: this is in the act, the behaviour of eating. Not in response to the substance or specific nutrient (eg: fat or sugar). Basically, if you really love the food you're eating, this reward system is activated. In my case, the act of eating peanut butter or chocolate, or both.

An offending meme: It looks legit and everything, it uses complex words like "insulin" and "dopamine"...
But there is no scientific link between sugar and addiction. Blood glucose levels dropping after eating any food with carbohydrates is not indicative of addiction, it's indicative of digestion and your body working correctly. 
In my research of this topic, I came across several points I wanted to share with anyone pedalling the idea of sugar addiction:
  • Calling certain foods or nutrients "addictive" implies they possess an inherent property making a susceptible individual addicted to it (which is the case for chemical substance abuse), NOT the case for sugar or fat
    • You are therefore giving food (or a particular nutrient) a "power" it does not have
  • Calling overeating "food addiction" neither explains overeating nor offers strategies for successfully reducing it
    • There is simply not enough evidence to validate or reject "food addiction"
    • Categorising a "food addiction" now, while evidence is insufficient to do so, risks trivialising serious and validated addictions
Just so you know, in recent years the amount of added sugar Americans eat has significantly decreased, mostly because soda consumption has decreased (yay!) BUT, the average American is still eating more sugar than is recommended. And FYI,  <10% of your daily calories should come from sugar, read more on that here.

In summary:
  • There is insufficient evidence of "food addiction" in humans, this includes substances and nutrients in foods like sugar or fat (1, 2, 3, 4, 5, 6)
  • The more correct notion is that people enjoy eating specific kinds of food that are often high in fat and sugar, and that the behaviour stimulates reward centers in the brain
  • These conclusions are not a green light to eat lots of sugary and fatty foods, because there is an mountain of evidence linking excess consumption of these to all manner of chronic diseases and death... just not by way of addiction
  • I love memes as much as the next guy, but they are unscientific sound bites, not facts!
If you're still reading, I've used this meme in other articles and I love it...
But not because it's true.