Are Simple Carbohydrates Physiologically Addictive?

Food addiction: an examination of the diagnostic criteria for dependence

The evidence for food's addictive properties is steadily growing. In addition to clinical and evolutionary plausibility, the possibility of addiction to food is supported by animal model research and increasingly by research with humans. Much as classic drugs of abuse "hijack" the brain, accumulating evidence with food suggests a similar impact, but with weaker effects. Although neurobiological evidence for food addiction is compelling, dependence as conceptualized with respect to alcohol and other drugs of abuse is fundamentally a behavioral disorder. Thus, we review the current state of food addiction research in the context of each of the diagnostic criterion for dependence (ie, tolerance, withdrawal, loss of control) and briefly explore other relevant addiction topics such as expectancies, reinforcement, and incentive salience. There is substantial evidence that some people lose control over their food consumption, suffer from repeated failed attempts to reduce their intake, and are unable to abstain from certain types of food or reduce consumption in the face of negative consequences. Although there is some evidence for other dependence criterion, further research is needed to examine tolerance and withdrawal to high-fat sweets, time spent in obtaining, using, and recovering from excess food consumption and the degree to which important activities are given up due to overconsumption. As science continues forward and both the public and elected leaders become aware that food may trigger an addictive process, this information will likely be used to inform policy. Thus, researchers need to carefully consider the implications of their work and the way in which the results may be interpreted.

Is sugar consumption detrimental to health? A review of the evidence 1995-2006

Many countries set quantitative targets for added sugars, justifying this by expressing concern about the likely impact of sugar on weight control, dental health, diet quality, or metabolic syndrome. This review considers whether current intakes of sugar are harmful to health, and analyses recent literature using a systematic approach to collate, rank, and evaluate published studies from 1995-2006. Results from high quality obesity studies did not suggest a positive association between body mass index and sugar intake. Some studies, specifically on sweetened beverages, highlighted a potential concern in relation to obesity risk, although these were limited by important methodological issues. Diet adequacy appeared to be achieved across sugar intakes of 6 to 20% energy, depending on subject age. Studies on metabolic syndrome reported no adverse effects of sugar in the long-term, even at intakes of 40-50% energy. The evidence for colorectal cancer suggested an association with sugar, but this appeared to have been confounded by energy intake and glycemic load. There was no credible evidence linking sugar with attention-deficit, dementia, or depression. Regarding dental caries, combinations of sugar amount/frequency, fluoride exposure, and food adhesiveness were more reliable predictors of caries risk than the amount of sugar alone. Overall, the available evidence did not support a single quantitative sugar guideline covering all health issues.

Abuse potential of carbohydrates for overweight carbohydrate cravers

RATIONALE

The long-rejected construct of food addiction is undergoing re-examination.

OBJECTIVES

To evaluate whether a novel carbohydrate food shows abuse potential for rigorously defined carbohydrate cravers, as evidenced by selective self-administration and mood enhancement during double-blind discrimination testing.

MATERIALS AND METHODS

Discrete trials choice testing was performed with 61 overweight (BMI m = 27.64, SD = 2.59) women (ages 18-45; 19.70% African American) whose diet records showed >4 weekly afternoon/evening emotional-eating episodes confined to snacks with carbohydrate to protein ratio of >6:1. After being induced into a sad mood, participants were exposed, double-blind and in counterbalanced order, to taste-matched carbohydrate and protein beverages. They were asked to choose and self-administer the drink that made them feel better.

RESULTS

Women overwhelmingly chose the carbohydrate beverage, even though blinded. Mixed-effects regression modeling, controlling for beverage order, revealed greater liking and greater reduction in dysphoria after administration of the carbohydrate beverage compared to the protein beverage but no differential effect on vigor.

CONCLUSION

For women who crave them, carbohydrates appear to display abuse potential, plausibly contributing to overconsumption and overweight.

Mood state effects of chocolate

BACKGROUND

Chocolate consumption has long been associated with enjoyment and pleasure. Popular claims confer on chocolate the properties of being a stimulant, relaxant, euphoriant, aphrodisiac, tonic and antidepressant. The last claim stimulated this review.

METHOD

We review chocolate's properties and the principal hypotheses addressing its claimed mood altering propensities. We distinguish between food craving and emotional eating, consider their psycho-physiological underpinnings, and examine the likely 'positioning' of any effect of chocolate to each concept.

RESULTS

Chocolate can provide its own hedonistic reward by satisfying cravings but, when consumed as a comfort eating or emotional eating strategy, is more likely to be associated with prolongation rather than cessation of a dysphoric mood.

LIMITATIONS

This review focuses primarily on clarifying the possibility that, for some people, chocolate consumption may act as an antidepressant self-medication strategy and the processes by which this may occur.

CONCLUSIONS

Any mood benefits of chocolate consumption are ephemeral.

Food craving and food "addiction": a critical review of the evidence from a biopsychosocial perspective

Although certain commonalities exist between eating and drug use (mood effects, external cue-control of appetites, reinforcement, etc. ), it is argued that the vast majority of cases of (self-reported) food craving and food "addiction" should not be viewed as addictive behavior. An explanation is proposed that instead gives a prominent role to the psychological processes of ambivalence and attribution, operating together with normal mechanisms of appetite control, the hedonic effects of certain foods, and socially and culturally determined perceptions of appropriate intakes and uses of those foods. Ambivalence (e.g., "nice but naughty") about foods such as chocolate arises from the attitude that it is highly palatable but should be eaten with restraint. Attempts to restrict intake, however, cause the desire for chocolate to become more salient, an experience that is then labelled as a craving. This, together with a need to provide a reason for why resisting eating chocolate is difficult and sometimes fails, can, in turn, lead the individual to an explanation in terms of addiction (e.g., "chocoholism"). Moreishness ("causing a desire for more") occurs during, rather than preceding, an eating episode, and is experienced when the eater attempts to limit consumption before appetite for the food has been sated.