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Volume 15, Number 4

The Merriam-Webster dictionary defines “sweet tooth” as “a craving or fondness for sweet food.” Many people, including me, would acknowledge having a strong affinity for sugary foods. Is sugar an addictive substance? In a recent review article published in Frontiers of Psychology, the authors point out how evidence from both animal and human studies indicate that five out of eleven criteria for substance use disorder are met with respect to sugar. These five criteria are use of larger amounts and for longer than intended, craving, hazardous use (i.e., risky, unhealthy), tolerance, and withdrawal. These studies involve brain neurochemistry, as well as behavior. The authors of the article suggest that sugar addiction is more comparable to nicotine or caffeine addiction than it is to cocaine or heroin addiction.

Common sugar, or sucrose, is a molecule composed of glucose and fructose. Although glucose is what cells burn for energy, it does not need to be consumed since the body itself converts amino acids into glucose. There is no biological requirement for fructose. This means that there is no dietary requirement for common sugar.

Excessive sugar intake is implicated in the obesity epidemic, increasing rates of Type II diabetes, and at least indirectly in cardiovascular diseases and cancers. It is estimated that nearly three-quarters of foods in grocery stores contain added sugar, primarily in processed foods. Sugar consumption in the United States is estimated to be approximately 18 teaspoons daily, with similar amounts in the United Kingdom and Australia. A primary component of this excessive consumption is sugar sweetened beverages (SSBs).

Some obesity experts describe our environment as “toxic” with respect to what people eat, in that readily accessible high-density food that is experienced as satisfying makes it exceedingly difficult to consistently maintain healthy diets. For someone with a “sweet tooth,” simply knowing what is healthy is often insufficient for resisting consumption of available sugary foods or beverages. However, changing the accessibility of such foods, with economic factors such as taxes or with changes in the physical environment, has been demonstrated to impact behavior.

Approximately 40 countries and several jurisdictions in the United States have implemented taxes on SSBs. Evidence from Berkeley, California and Philadelphia, Pennsylvania indicate that SSB consumption decreases with such taxation. An article in the February 2019 issue of the American Journal of Public Health estimates that a national one cent per ounce tax on SSBs would result in a savings of over $45 billion in lifetime healthcare costs, an estimate the authors purport to be conservative.

From an addiction perspective, craving sugar and consuming sugar begets more cravings. While there may be gradual public health and legislative efforts aimed at making the food environment in the United States less toxic, at this point managing one’s sweet tooth is largely an individual challenge. One step an individual can take is managing what foods are readily accessible in controllable environments, such as one’s home. Although it can be difficult, developing the habit of not consuming SSBs or added-sugar foods is one important factor in maintaining a healthy diet.

Paul J. Hershberger, Ph.D.

… is a clinical health psychologist. He is Professor, Director of Research, and Director of the Division of Behavioral Health, Department of Family Medicine, Wright State University Boonshoft School of Medicine.


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