no sugar or flour, food addiction?

ninerbuff wrote: »

cmriverside wrote: »

5. Conclusions

The results of the current systematic review generally support the validity of food addiction as a diagnostic construct, particularly as it relates to foods high in added sweeteners and refined ingredients. The majority of studies in the current review reported evidence for symptoms related to neurological changes and impaired control, with fewer studies evaluating preoccupation, chronicity, relapse, social impairment, and risky use. Behavioral and substance-related aspects of food addiction appear to be intertwined, but we suggest that the substance (highly-palatable food) component may be more salient to the diagnostic classification of this phenomenon than the behavior (eating). We propose that the food addiction construct merits serious attention in regard to its presentation, prevention, and treatment in humans.

The concept of food addiction remains controversial [25,30,31]. Some researchers question whether food or eating can be addictive if it is necessary to our survival [25], while others point out the common biological (e.g., brain reward pathways, ΔFosB expression), behavioral (e.g., relapse, using more than intended), and psychological (e.g., preoccupation, impaired control) similarities between the compulsive consumption of highly palatable foods and use of addictive drugs [2,32,33]. Nevertheless, critics and proponents alike agree that more research is needed to confirm the validity of food addiction [30,34]. A non-systematic review by Hone-Blanchet and Fecteau [31] comparing animal and human models of food addiction to characteristics of substance use disorder concluded that there was significant overlap between the two conditions, but that more research was needed. Extant published systematic reviews on the concept of food addiction have either conflated obesity with food addiction or excluded animal studies [22,28,29]. As such, a more recent and inclusive systematic review was needed. The present systematic review aimed to summarize the peer-reviewed empirical literature examining the evidence for food addiction in both animal and human studies. The chosen method involved assessing its association with key characteristics of addiction in relation to food: (a) neurobiological changes, (b) preoccupation with the substance, (c) impaired control, (d) social impairments, (e) risky use, (f) tolerance/withdrawal, (g) chronicity of the condition, and (h) relapse [1,10,17].

While there is some evidence to show it "may" be an addiction, I'm still not fully convinced it is. I'm NOT dismissive that people don't struggle with food, carbs, sweets, etc., but I do believe that mixed information can lead them to believe they may be hopeless so why even bother? Trust that I've dealt with many a client with that attitude when they first hit their first stall. When I get them to believe it's not an actual "addiction", they seem to not struggle as much and their discipline gets better. Anyway, there is no set concensus by science, so I'll still stick to it not being an addiction till science actually identifies it as such.

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In this particular context, a lot hinges on whether the particular individual we're trying to help thinks "addiction = I'm powerless to change" vs. "addiction = treatable condition that can be changed with the right interventions". From reading this thread, it seems like people here have had varying reactions to the term, loosely on that kind of interpretive scale.

(That's leaving out the people who truly do use the word casually, which is certainly a thing that happens.)

LifeChangz wrote: »

cmriverside wrote: »

Making food addiction or similar a "diagnostic classification" has HUGE financial and regulatory implications. I'm not sure we'll get there in my lifetime due to insurance companies, food manufacturers, and government programs like Medicare/Medicaid, but I think the pharmaceutical companies will have a hand in changing the diagnostics. There are already several drugs that are able to have an effect on compulsive over-eating, so it should be a great debate.

I believe a diagnostic criteria will happen someday, but a whole lot more nuanced conversation and discussion is going to be needed, IMO. The wheels turn slowly.

agreed. the newest food pyramid is a good illustration of the influence of big business on regulators. Any particular food company has a goal to make money irrespective of the impact on the health and well being of the consumer, so immediate pleasure is advertised as a selling point. I would guess things won't change until a change is required - think tobacco advertising and regulation changes. Changes did not happen voluntarily.

In the US, there is no current "food pyramid". There formerly was one, and (statistically speaking) very few people ever paid the slightest attention to it, as measured by evidence about their food choices. If more people followed the actual current My Plate guidelines, not just the cutesy intro graphic but the actual easy-to-read details, the nation would be much healthier than it is now. Much.

I'm not disputing the addiction model specifically here, but I think blaming USDA (or WHO, etc.) guidance for real-world outcomes is pretty misplaced. We ignore them.

I agree that food companies exist to make money, but also think that means they're highly motivated to figure out what we will vote with our dollars that we want to consume. For reasons of culture, history, and even natural selection, we seemingly want to consume things that are high in fats, sweetness (sugar and other forms), and salt. Speaking only for myself, I do expect companies to serve my wants, not be my nanny. (The FDA/USDA should be at least a little bit nanny, but like I said, we do ignore them anyway.)

If our dollars voted for read-to-eat, single-serve, ecologically-responsible packs of organic roasted brussels sprouts, the companies would be falling all over themselves to produce the best, the most affordable versions, and they'd be on every shelf and spinner rack in stores all over the country; happy pretty young people would be nomming down on XYZ brand Super-Sprouts in all the ads.

If you've been alive long enough to observe, think about the initial introduction (around 1975) of granola bars that were actually semi-nutritious, and how they evolved with time into mostly candy bars with a veneer of virtue. (Protein bars seem to be going that route, too.) Think about McDonalds introducing salads (late 1980s) under pressure to have healthy options. It advertised them pretty heavily, then increasingly turned to variations with crispy chicken, bacon-ranch, and other fatty, salty add-ons in an effort to sell more, and more recently minimized salads almost entirely. It's demand driven.

I also don't personally like perspectives - like the "nefarious food companies" idea - that IMO over-minimize our own individual power of choice. Acknowledging that power of choice - present at least for those of us without addiction under any sensible definition - is potentially uncomfortable, because it implies personal responsibility.

There are enough institutional forces in the world at large that would like to disempower me; I don't need to collaborate in that.

And yes, I think it's possible not to be addicted (under any definition) to so-called hyperpalatable foods, though I wouldn't speculate about whether it's common. Statistics suggest people consume lots of those foods, admittedly, but I think the reasons why are a little complicated.

i would agree that more research is needed/be done.

prior to the emerging information and discussion which i first stumbled on about 2010, i did not characterize my personal struggle as a food addiction - I did not describe that in those terms, using the language used for alcohol and drug addiction - it never occurred to me. I did try to describe, in personal experience/layman's terms to my doctors the nature of the physical struggle, and no one ever suggested anything in terms of food addiction nor even eating disorders which were still emerging and being identified too. The identified disorders anorexia and bulimia did not fit me... I had an epiphany when I stumbled across binge eating, and thought, ah, that describes the start/stop, starve/feast pattern I had stumbled into through fad crash dieting, but it was always in the stopping that the physical difficulty/withdrawals expressed. And that is the part that was never recognized when I tried to express it. So, when I stumbled across the early discussions of food addiction, as described in Kessler's book 'the end of overeating', I had the rest of the ah ha moment, and a new language to describe it.

why do I share this - as a non-technical person, it gives a basis for characterizing the whole overall problem and a language to assess and establish recovery/treatment paths forward. It is actually empowering to recognize, hey, yes, this is real... and recognizing and accepting it does not mean staying stuck in the problem, it means recognizing just how dang serious it is and do what needs to be done...

with respect to alcohol/drugs and a food comparison - i consider the myriad of the hyper-palatable foods to be the equivalent of a gazillion choices like there are a gazillion choices of alcohol drinks or all the edible/smoking ways to consume various drugs... the compulsion/addiction for the people who struggle with it expresses in the seeking/using/abusing/can't stop/crawl the wall physical and emotional struggles that ensue, impair their lives to some degree or death in the end if the addiction is not arrested and treated. I personally think food addiction is as dang serious as alcohol, drug and cigarette, shopping, gambling or any other recognized addiction. It destroys lives for those who lose the battle... Recognizing food addiction is a real problem for some, not all, people allows for a common support/treatment path forward... which is in an infant state compared to recognition and treatment for people addicted to drugs or alcohol.

jmho - but i imagine further research will strengthen recognition of a medical diagnosis and treatment support. at least, that is my hope.

I have to be an abstainer. It is possible to avoid all added sugar in your diet. All of it. It's very hard and it's very limiting. Sugar is acting on the brain to make a dopamine reward. Sugar has no nutritional value and creates inflammation in the body and changed gut bacteria. Before you yell at me, I have done tons of research on this before I agreed to eat this way. It was my doctor who wants me to eat this way as part of an autoimmune diet. I wasn't going to do this without solid proof. No woo here. I don't enjoy it but everytime I fall off the wagon my symptoms reappear. It's very hard to go off sugar. I was a mess. If I cheat I'll start craving sugar and then I can't control myself. I will eat an entire package of cookies Im not even joking. Addiction runs in my family and I can tell you that I'm not certain clinically speaking of sugar is addictive but I have to stay away from it all together on order to control myself. I also would like to stay off pain pills, and immune modified drugs for my condition ( ankylosing spondylitis).

LifeChangz wrote: »

@AnnPT77 ~ thank you...

i'm going to intermix reply with additional thoughts in a stream of conciousness response... for the sake of discussion... I do appreciate your posts - gave me much to ponder.

Regarding current food pyramid; not sure I had realized that the food pyramid was technically replaced by the myplate in 2011. I grew up using the pyramid and myplate, still do. More broadly speaking though, pyramids are still used on a widespread basis in "diet" literature of all sorts (so not USDA/US government currently) - within current diet literature found widespread on internet; i can almost visualize pyramids for many different food approaches in the literature, some hand in hand with the my plate guidelines, which are visually helpful to construct meals. I think my point with the pyramid is the bottom/biggest part is carbs, smallest top is fats, but for those who struggle with some threshold of a 'food addiction' response to 'hyper-palatable' foods (previously described earlier throughout thread), the food pyramid/my plate doesn't really address a distinction that is easily discernible... my wish list - I would like to see 'food addiction recovery guidelines' developed that people/medical community could use to help people normalize stable eating. Some groups have these like OA or Brightline, but, well, nothing formal on this that i've found from USDA...

(snip rest of post, mostly about food companies, to focus on the above)

The US food pyramid circa 1992 didn't literally have carbs at the base. The base was the "Bread, Cereal, Rice and Pasta Group" (yes, those contain carbs, but also fats and proteins). At the top it did have "Fats, Oils and Sweets", with a "use sparingly" comment, and it was clear that that top bit included added sugars, not just fats. I'm not going to try to respond to other food pyramids elsewhere on the web, but if we need to analyze a decade(s) old paradigm pyramid, that was the starting point pyramid in the US.

I'm not sure what you're looking for in the way of "food addiction recovery guidelines" so I won't try to parse out how the "My Plate" site (whole thing, not just the graphic) relates. (I've read quite extensively on that site, as an aside, just out of interest, and partly because it seems like so many people here criticize it so I was curious.)

Yes, My Plate guidelines do include foods with carbs, but in My Plate they're still not emphasized as such. For example, for my approximate maintenance calories of about 2200 daily, I'm recommended 2 cups of fruit, 3 cups of vegetables, 7 ounces of grains, 6 ounces of protein foods, 3 cups of dairy foods. If I click through, I get more rational serving-size guidance (vs. cups) for foods in each of those categories.

Clearly, there are carbs in there (plus fats and protein). I would guess that the most likely categories for carb-rich "hyperpalatable" foods to appear would be the veggies (because potatoes) and grains (because all those flours and pastas and things)?

If I click through on the veggies, potatoes are in the table of examples in the form of boiled, baked, mashed. No chips, no fries.

In the grains, the verbiage when I click through hypes up the value of whole grains very strongly, and suggests that if a person does choose refined grains, they should be enriched. The examples given of refined grains are white flour, corn grits, white bread, and white rice. The tables include more forms of those types of things (crackers, cereals, etc.), but no cookies, cakes, etc.

To me, this seems like a pretty sensible approach to eating, and carbs vs. fats are not explicit in the goals (at least not presented until a person digs to find them, which I didn't). What's emphasized is servings of the categories I mentioned above. Even at the simple logo-graphic level, half the plate is fruits and veggies (more of veggies than fruits), a quarter-plate each is protein foods and grains, and dairy is shown in a small circle to the side.

The site describes an app, "Start Simple With My Plate", which appears to be a 'gradually remodel your eating' kind of approach, where you pick goals of small changes in your diet that sound achievable, then the app gives you tips and reminders, and sort of game-ifies accomplishing those goals with badges and what-not. Here's part of a representative graphic about that downloadable app.



I agree that people who may have food addictions may require psychological or social support in order to foster change in their lives. But I don't really expect psychological support or analysis from USDA or FDA, given their mission. (There are various government sites with links to the National Eating Disorders Association, which seems to be a nongovernmental non-profit organization.)

The things on the My Plate site seem to me to provide a pretty easy roadmap of the practical food selection and nutrition side for people who can commit to change in their eating patterns. If there's any pandering to food companies or hyperpalatable foods . . . it's pretty well buried or disguised, as far as I can see.

Speaking personally, the largest macronutrient in my daily eating is in fact carbs. I don't count them (except by default, by logging), don't care where they fall, only focus on hitting my fat and protein minimums and getting truly large amounts of veggies/fruits.

But if I look back retrospectively at MFP totals, I do tend to be eating around 50% carbs, usual range is maybe 46%-52% as a weekly average. The carbs I'm eating mostly come from the fruits, the veggies, no sugar added dairy, a few grains (mostly whole grain stuff, some refined) - pretty much the kinds of foods that My Plate recommends, even though I'm not intentionally using My Plate as a guide, just eating in a way I've found I personally like to eat. (I guess I'm lucky in that regard, that I'd genuinely rather have an apple or some prunes than (ugh) an Oreo or a sugary cereal. The occasional chocolate is nice, but those are mostly fat calories.)

Given all of this, I find the frequent Debate Club focus on carbs somewhat odd. Usually, the hyperpalatable foods named are a combination of carbs and fats, IME often foods with more calories from fats than carbs, some salty, some not.

A healthy way of eating need not include lots of carbs, and for sure some people do better when minimizing carbs - either for reasons of appetite or health conditions. But a sort of generic healthy diet also can include really a lot of carbs, 50% or more. It doesn't seem like low carb content is universally a key factor for health.

It would make more sense to me to put the stronger emphasis on so-called hyperpalatable foods (I can't bring myself to call them hyperpalatable outright, personal bias), or on highly refined foods, or high fat/sugar low nutrient foods, or something like that. Calling out carbs per se as the big deal seems odd to me.

Healthy diets can include a lot of carbs, unhealthy ones often seem to have more calories from fats than carbs, or at least close. (Are the fat-marketers getting away with something here these days? Yes, it seems like there used to be lowfat guidance from the feds - I'm not seeing that explicitly in My Plate much either, other than little bit in the dairy foods area and some encouragement toward lean meats, more emphasis on whole foods generally. There's ample evidence that the population at large ignored the lowfat guidance anyway.)

I freely admit that I've not ever considered myself a food addict, even when I was overweight to obese for decades, so I won't pretend to experiential knowledge about that. I also admit that for essentially all of my adult life (50-ish years, as I'm 67), as noted I've not really enjoyed what most people mean when they refer to hyperpalatable foods.

Yes, I've sampled most of those foods, eaten some now and then, a few of them somewhat often but off and on. In general I find most of the foods called that to be not very tasty, not very satisfying, over-simple, not worth the money, not worth the time . . . even when I wasn't worried about how many calories I ate. (And I'll underscore that I managed to reach obesity eating lots of whole foods, not many of the things usually categorized as junk food, hyperpalatable, fast food, etc. Well, except maybe pizza, which is easy to overeat but tends to be somewhat balanced-macros IME.) Viscerally, I mostly don't get the "hyperpalatable" label, personally. (I'm saying I seem to be an outlier somehow taste-wise, not saying I think others are wrong or misrepresenting themselves.)

I've been at least well on the slippery slope to attachment or dependence on other substances/behaviors a few times, so it's not that I don't have any hint of addictive inclination. It wasn't food, so no need to go into details here, I think. The point is that I'm not some kind of strong, disciplined character . . . more of a hedonist, honestly.

neanderthin wrote: »

Maybe I should have just said, eat whole food more lol. Cheers

If you were replying to my stupid-long essay, I owe you an apology. I didn't intend to be replying to you, that quote was an accident, somehow. I've edited it out.

right, so the guidelines are balanced, practical and helpful for regular eating, regular foods, and they are the goal.

for definition/understanding - the idea would be that a person struggling with food addiction tends to overeat the 'hyper-palatable' foods; a definition created/provided by various authors. The first time I encountered it was in Kessler's book 'the end of overeating' - the term without contextual understanding, the term doesn't really make sense other than a simple literal interpretation could mean food that really tastes super good - but for food lovers that could easily apply to any food.... It is the premise that the hyper-palatable foods/combination of foods is what ignites the chemical response in the brain, triggering the addictive response for some people.

the addictive response to certain foods similar to an addictive response to alcohols, drugs, cigarettes; of a 'can't stop overeating'... er, physical and behavioral compulsions, i think, is driven beyond normal eating - the food pyramid and myplate guidelines would be the endpoint goal/moving from addictive eating to regular eating. 1 of the main therapeutic approaches for eating disorders is to 'normalize/stabilize' eating - often using those guidelines. For some, however, foods with carbs/flours/sugars, combined with fats/salts can keep the physical going and may need to be avoided - so this would vary in that respect from the standard food pyramid/myplate models.

anyhoo, i get lost in trying to express this... and, yes, perhaps the eating guidelines should refer to the national eating disorders information for adjustments/approaches for people with these kinds of issues - which could include help for recovery from the compulsive overeating of whatever foods the person is struggling with - most often the 'hyper-palatable' variety - and too often, to the exclusion of other foods. In the absence of the 'hyper-palatable foods' ~ a person in the throes of withdrawals or increasing tolerance will eat anything... even if the only thing is, let's say pickles or non-starchy veggies, the person may consume them and stop until can acquire more food the next day - or leave the house and hit drive thrus or order delivery... i had a roommate who ate sugar straight from the cannister in the absence of her preferred foods. It is easy to seek alternatives to the preferred food; substitues are available and cheap and easily obtained.

my thought regarding addiction is that it is progressive and strengthens over time for some people, not all people.... starting rather innocculously enough and often simply as reasons for everyday feasting or social eating with friends - like after a football game... and the person may not experience withdrawals or difficulties... until they try to stop or resist and begin to experience withdrawals. Recognizing this is a real problem, having a common language to discuss it will allow the person to seek solutions, collaborate with medical and social support.

imho, it's a good thing. it's way bigger, impacting so many people, and a dire need that still needs to be addressed in health care policies/institutions/dietary guidelines and other support - just like alcohol abuse/dependence is provided multi-disciplinary paths for recovery.

I get lost in the technical speak, and the fine details, and don't retain the whatnots - but have settled on the side of 'food addiction is a real thing' ~ imho it gives society a common understanding, language and place to start pulling together effective help for people who do suffer; whether it ends up being classified as some sort of behavioral/eating disorder or a medical diagnosis or both... it's bigger than my own thoughts on this, and it has taken a lot of thought, reading all the threads and courage to even post my thoughts about it.... but I think I've said about all I have to say on it at this point.... I look forward to further research and evolving thinking on the subject.... methinks we've only just begun to see progress with this issue.