Dr. Mark Gold’s Research You Can Use
Young people enjoy and consume the most significant amounts of sugar-sweetened beverages than any other age group in the U.S. As a consequence, they have also experienced the most substantial associated gains in obesity levels, which quadrupled over the course of past several decades.
However, a recent study has confirmed that these tasty beverages, known for increasing the risk of diabetes and other chronic diseases, may actually be addictive as well.
Even though there is substantial evidential support of the addictive properties of sugar and caffeine, the key ingredients in these beverages, there exists limited research into such properties of sugar-sweetened drinks in naturally occurring consumption patterns. Hence, this exploratory study aimed to examine the potential addictive properties of sugar-sweetened beverages during a cessation period.
Excessive sugar-sweetened beverage consumption a global concern
Limiting the excessive consumption of sugar-sweetened beverages has quickly developed into a global public health priority, due to consequential increases in obesity and cardiometabolic diseases. These drinks are also the most significant contributors to added sugar in diets across multiple countries.
Unlike most foods, the sugary beverages have unique characteristics that promote the overconsumption of calories. The biggest reason for this is that liquid calories, in comparison to calories from solid foods, are less satiating and incompletely compensated for by eating lesser calories for the rest of the day.
Secondly, the essential ingredients of these beverages, that is caffeine and sugar, are already established as having addictive potential. Caffeine withdrawal is an official disorder, as recognized by the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). The continued use of caffeine regardless of harmful consequences, such as insomnia and hypertension, has been affirmed through a body of evidential data and caffeine dependence syndrome is established by the International Statistical Classification of Diseases and Related Health Problems (ICD-10).
My colleagues and I have spent decades exploring the addictive potential of sugar. While the work is comparatively new, it has been extended by Nicole Avena and Ashley Gearhard. Most of the studies conducted have been based on the animal model, depicting parallels between added sugars and substances of abuse in situations like bingeing, cravings, development of tolerance and withdrawal symptoms.
The Yale Food Addiction Scale and work of Gearhardt at Michigan has been pivotal. Human neuroimaging studies have also shown the activation of similar neural circuitry and reward systems in instances of high sugar intake as those that occur with substances of abuse.
It is essential to understand that naturally occurring sugar, such as that found in fruits, is quite distinctive from added sugars that are extracted, concentrated and separated from the nutrients in their original forms. The processes of this extraction and concentration are comparable to that of addictive substances like opium from poppies or ethanol from fruits.
Adolescence, itself, is a vulnerable age where susceptibility to addiction is much more significant as the brain is still developing.
As individuals transition into their teenage years, they acquire greater independence in buying food and more exposure to advertisements promoting sugar-sweetened beverages.
According to the estimates by the Federal Trade Commission, Carbonated drinks topped the food category list with the highest marketing expenditure directed toward teens only, totaling almost $400 million in 2009.
This study aimed to assess the extent to which these sugary beverages can be addictive among overweight and obese adolescents who consumed high amounts of sugar-sweetened beverages. A total of 25 participants were recruited for the study, aged 13 to 18 years, with 72 percent of the sample population being female.
Potential addictive properties of sugar-sweetened beverages were assessed during a 3-day cessation period in the participants who typically consumed more than three sugary drinks a day. Withdrawal symptoms and cravings for the drinks were evaluated at an approximately 1-week interval, during periods of regular consumption of sugary beverages and the 3-day period of cessation in which participants were instructed to drink only plain water and milk.
The adolescent participants reported increased cravings for the drink accompanied by physical consequences including headaches, lower motivation, decreased contentment, inability to concentrate and overall reduced feelings of well-being. The answers were recorded on a 5-point response scale, ranging from 0 (not at all) to 4 (very much). Participants filled out the scale on the first two days of regular intake and one week later, on each cessation day.
After controlling for the false discovery rate, fluctuations in motivation, craving, and well-being remained significant.
Why is this important?
The consumption of sugar-sweetened beverages has escalated five-fold since the 1950s and is continued to be consumed in magnanimous quantities still. This is regardless of the increased publicity and greater public awareness of the associated health repercussions.
“An abundance of research points to sugary drinks as contributing to a number of chronic diseases. Our findings—that these drinks may have addictive properties—make their ubiquitous availability and advertising to youth even more concerning for public health,” said Jennifer Falbe, assistant professor in the Department of Human Ecology in the College of Agricultural and Environmental Sciences at UC Davis and the lead author of the article.
Future studies need to recruit larger sample sizes and evaluate withdrawal symptoms over longer durations of time and enrolling both normal and overweight participants.
Neuroimaging studies among younger children, combined with longitudinal assessments of sugar-sweetened beverage consumption, anthropometrics, and metabolic outcomes could further help determine the direction of the relationship between addictive responses to sugary drinks and weight status.
The addiction model predicts that sugar consumption initiated in adolescent years becomes an ingrained part of a diet and use quickly becomes excessive.
Lustig and his UCSF colleagues have suggested consumption may be toxic and cause diseases of the liver and elsewhere. In the face of heavy marketing to maintain high consumption levels, we see increasing health consequences among the adolescent population.
Studying and determining the addictive potential of these sugary beverages may hold important implications for future regulations, public health campaign, taxation and obesity treatment.
5. Avena NM, Potenza MN, Gold MS. Why Are We Consuming So Much Sugar Despite Knowing Too Much Can Harm Us? JAMA Intern Med. 2015;175(1):145–146. doi:10.1001/jamainternmed.2014.6968
About the Author:
Mark S. Gold, M.D. served as Professor, the Donald Dizney Eminent Scholar, Distinguished Professor and Chair of Psychiatry from 1990-2014.
Dr. Gold was the first Faculty from the College of Medicine to be selected as a University-wide Distinguished Alumni Professor and served as the 17th University of Florida’s Distinguished Alumni Professor.
Learn more about Mark S. Gold, MD
About the Transcript Editor:
A journalist and social media savvy content writer with extensive research, print and on-air interview skills, Sana Ahmed has previously worked as staff writer for a renowned rehabilitation institute, a content writer for a marketing agency, an editor for a business magazine and been an on-air news broadcaster.
Sana graduated with a Bachelors in Economics and Management from London School of Economics and began a career of research and writing right after. Her recent work has largely been focused upon mental health and addiction recovery.
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Published on January 30, 2019.
Reviewed & Approved on January 30, 2019, by Jacquelyn Ekern MS, LPC
Published on EatingDisorderHope.com