Review
Evidence for sugar addiction: Behavioral and neurochemical effects of intermittent, excessive sugar intake

https://doi.org/10.1016/j.neubiorev.2007.04.019Get rights and content

Abstract

[Avena, N.M., Rada, P., Hoebel B.G., 2007. Evidence for sugar addiction: Behavioral and neurochemical effects of intermittent, excessive sugar intake. Neuroscience and Biobehavioral Reviews XX(X), XXX–XXX]. The experimental question is whether or not sugar can be a substance of abuse and lead to a natural form of addiction. “Food addiction” seems plausible because brain pathways that evolved to respond to natural rewards are also activated by addictive drugs. Sugar is noteworthy as a substance that releases opioids and dopamine and thus might be expected to have addictive potential. This review summarizes evidence of sugar dependence in an animal model. Four components of addiction are analyzed. “Bingeing,” “withdrawal,” “craving” and “cross-sensitization” are each given operational definitions and demonstrated behaviorally with sugar bingeing as the reinforcer. These behaviors are then related to neurochemical changes in the brain that also occur with addictive drugs. Neural adaptations include changes in dopamine and opioid receptor binding, enkephalin mRNA expression and dopamine and acetylcholine release in the nucleus accumbens. The evidence supports the hypothesis that under certain circumstances rats can become sugar dependent. This may translate to some human conditions as suggested by the literature on eating disorders and obesity.

Section snippets

Overview

Neural systems that evolved to motivate and reinforce foraging and food intake also underlie drug seeking and self-administration. The fact that some of these drugs can cause addiction raises the logical possibility that some foods might also cause addiction. Many people claim that they feel compelled to eat sweet foods, similar in some ways to how an alcoholic might feel compelled to drink. Therefore, we developed an animal model to investigate why some people have difficulty moderating their

Defining addiction

Throughout this review we use several terms with definitions for which there is not universal agreement. Addiction research traditionally focuses on drugs of abuse, such as morphine, cocaine, nicotine and alcohol. However, recently a variety of “addictions” to non-drug entities, including gambling, sex, and in this review, food, have been investigated (Bancroft and Vukadinovic, 2004; Comings et al., 2001; Petry, 2006). The term “addiction” implies psychological dependence and thus is a mental

Drugs of abuse and palatable food activate a common subset of neural systems

Overlaps in the brain circuitry activated by food and drug intake suggests that different types of reinforcers (natural and artificial) stimulate some of the same neural systems (Hoebel, 1985; Hernandez and Hoebel, 1988; Kelley et al., 2002; Le Magnen, 1990; Volkow and Wise, 2005; Wise, 1989). There are several regions in the brain involved in the reinforcement of both feeding and drug intake (Kalivas and Volkow, 2005; Kelley et al., 2005; Koob and Le Moal, 2005; Mogenson and Yang, 1991; Wise,

Behavioral similarities between drug self-administration and intermittent, excessive sugar intake

The concept of “sugar addiction” has been bandied about for many years. Clinical accounts of “sugar addiction” have been the topic of many best-selling books and the focus of popular diet programs (Appleton, 1996; DesMaisons, 2001; Katherine, 1996; Rufus, 2004). In these accounts, people describe symptoms of withdrawal when they deprive themselves of sugar-rich foods. They also describe food craving, particularly for sugar and other carbohydrates, which can trigger impulsive eating. This leads

Neurochemical similarities between drug self-administration and intermittent sugar intake

The studies described above suggest that intermittent sugar access can produce numerous behaviors that are similar to those observed in drug-dependent rats. In this section, we describe neurochemical findings that may underlie sugar dependency. To the extent that these brain alterations match the effects of drugs of abuse, it strengthens the case that sugar, in some cases, can resemble a substance of abuse.

Discussion and clinical implications

Food is not ordinarily like a substance of abuse, but intermittent bingeing and deprivation may change that. Based on the observed behavioral and neurochemical similarities between the effects of intermittent sugar access and drugs of abuse, we suggest that sugar, as common as it is, nonetheless meets many of the criteria for a substance of abuse and may be addictive for some individuals when consumed in a “binge-like” manner. This conclusion is reinforced by the changes in limbic system

Conclusion

From an evolutionary perspective, it is in the best interest of humans to have an inherent desire for food for survival. However, this desire may go awry, and certain people, including some obese and bulimic patients in particular, may develop an unhealthy dependence on palatable food that interferes with well-being. The concept of “food addiction” materialized in the diet industry on the basis of subjective reports, clinical accounts and case studies described in self-help books. The rise in

Acknowledgments

This research was supported by USPHS Grants MH-65024 (to B.T. Walsh (Columbia) and B.G.H.), DA-10608 (B.G.H.), DA-16458 (fellowship to N.M.A) and the Minnie B. and E.H. Lane Foundations.

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