Are we addicted to carbohydrates? It’s almost impossible for some people to stay away from highly processed, sugar-filled junk food, despite being aware of the harmful effects of simple glucose on health. The reason for this insatiable sugar-rush is debatable. While some think this is simply a matter of willpower, others feel there is complex brain chemistry involved in this addiction.
India, a country where celebrations are ‘meaningless’ without sweets, is the largest consumer of sugar in the world. In 2021, Indians consumed 28 million metric tonnes of sugar, which was a million metric tonnes more than in the year 2020. Ironically, 80 per cent of all deaths in India are caused by cardiovascular disease, type 2 diabetes, cancer and other non-communicable diseases that are attributed to poor dietary habits such as mindless consumption of refined sugars.
What is refined carb addiction?
People who crave simple carbs like cakes, sweets, pastry, French fries, pizza and chips, binge on refined carbs to feel good for a little while and then feel an even stronger craving to eat more. This is an unstoppable, almost Pavlovian stimulus-response cycle that suggests refined carbs can be as addictive as some infamous drugs. According to research, psychological rewards from sugar and sweets are comparable to that of cocaine, and can sometimes be more rewarding and attractive as well.
Researchers from Yale University developed a validated measurement tool called the Yale Food Addiction Scale (YFAS) in 2009 to assess food addiction and related behaviours. The YFAS was tested by a group of university researchers to assess the addiction-like eating behaviour in 504 participants and found 92 per cent were addicted to some sort of food. The researchers concluded that processed foods with high fat and high carbs were most associated with food addiction.
According to a Healthline article, that utilised the YFAS between 1 (being not addictive) and 7 (being the most addictive), pizza emerged as the most, reaching a 4.01. Other items such as chocolate (3.73), chips (3.73), cookies (3.71) and ice cream (3.68) made the top five. Meanwhile, cucumbers (1.53), carrots (1.60), beans (1.63), apples (1.66) and brown rice (1.74) were the least addictive food products.
Notable research done by David Ludwig and his colleagues on 12 overweight and obese men aged 18 to 35 years reported that, unlike a low glycemic index (GI) meal, a high GI meal increased hunger and stimulated brain regions that control reward and craving. The glycemic index of a food is measured by how that food affects blood sugar levels.
In a 2018 review, while explaining the brain’s response to high GI food, researcher Belinda Lennerz mentions that in a group of vulnerable people, high GI carbs trigger “addiction-like neurochemical and behavioural responses.” Additionally, the authors mention high GI carbs change insulin and blood sugar levels rapidly and affect dopamine level — the neurotransmitter that controls brain-cells signalling pathways for pain, motivation, and reward.
It is to be noted that most experimental studies that explain sugar and addiction are conducted on animals. In this model, a 10 per cent sucrose solution and chow food mix were fed to lab rats, followed by a period of 12-hour fasting. The result reported the rats were found to be anxious during and after the fast.
In a trial, 61 overweight women aged 18 to 45 years with a history of emotional eating chose a carb-loaded beverage over a protein-rich one, even though they were blinded.
Another double-blinded, placebo-control trial with a similar study design revealed that when in a bad mood, known carbohydrate cravers chose the carbohydrate beverage significantly more than the protein-rich beverage and reported improvement in mood. The authors concluded the research to add weightage to the existing concept of carbohydrate craving syndrome.
Some researchers suggest fructose, sugar from fruit and honey, may cause addiction because fructose resembles the properties of ethanol, an alcohol. High fructose consumption leads to liver inflammation, abnormal fat accumulation, insulin resistance, and hedonic hunger — a model of compulsive eating to obtain pleasure under no energy deficit.
Constant exposure to hedonic hunger driven by the sugar rush is found to increase the risk of metabolic syndromes and inflammatory diseases.
Not everyone is convinced
Not all researchers are convinced by the ‘sugar addiction’ theory. A review suggests ‘food addiction’ is limited to a small population, and encourages more research to understand the addictive properties of food.
A review of existing literature on sugar addiction led by Margaret L Westwater and colleagues argues that there is a lack of studies to support sugar addiction in humans, and the reason for addiction-like behaviour like bingeing in animals might be because of their access to sugar at intervals, and not some neurochemical interplay.
A cross-sectional study involving 1,495 students concluded that sugar was not the only contributor to food dependence and elevated risk of weight gain.
How to get rid of the addiction?
The first step to overcome carb addiction is to understand that specific addictive behaviour towards a food can’t be tackled only by willpower. It requires a healthy lifestyle.
The first step is to throw all the heavy carb food from your fridge. Stay away from some of the most addictive foods such as pizza, chips, cakes, pastries, fries, etc. It is also wise to choose healthy food by practising mindful eating, which helps you identify the trigger.
Include protein-rich foods from both animal and vegetable sources in each meal to stay full for a longer time. Also, eat more fibre-rich foods like whole grains and whole fruits to avoid hunger pangs. The sweet taste in fruits helps with sugar cravings too.
Stay hydrated. Set an alarm to drink water or quench your thirst with watery foods like cucumber, watermelon, muskmelon. And also, be physically active. Choose a workout regime that combines both cardio and strength training. Take stairs whenever you can, walk at least 7,000 steps.
The most important part of changing your lifestyle is to be kind to yourself. Giving in to carb cravings is common. Take progressive steps to find a suitable technique to fight it.
It’s true that carbs are the most conventional sources of energy in the daily Indian diet. Not all carbs are bad. Some high fibre carbs like whole fruits, green leafy vegetables, oats, quinoa, millets are healthy and produce multiple health benefits. It’s the processed and ultra-processed foods high in salt, sugar and fat that collectively cause addictive behaviour in many individuals. However, more extensive research is needed to understand the mechanism of carb addiction in humans that involve some sort of neurological response.
Dr Subhasree Ray is Doctoral Scholar (Ketogenic Diet), certified diabetes educator, and a clinical and public health nutritionist. She tweets @DrSubhasree. Views are personal.
(Edited by Srinjoy Dey)