Addicted to Addiction Rhetoric

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Katie Ashwill, NWHN Health Information Intern
Fri, January 28, 2011

How often have we been told, by perhaps, an overzealous friend or family member, “I’m addicted to ____” (insert: Starbucks soy caramel macchiato lattes, Facebook, lip gloss)? When of course, what this friend really means, is that Starbucks soy caramel macchiato lattes have become an integral (and expensive) part of their morning routine, and that this friend applies lip gloss compulsively because it smells like strawberry shortcake. This hyperbolic “addiction” is a common speech device that effectively gets the point across. Your friend logs into Facebook five times a day to make sure s/he isn’t missing out on some titillating housewarming party invitation, and while this may not be healthy, it not likely a diagnosable addiction.

But addiction has its real place. In recent news, the concept of “food addiction” has surfaced, perhaps in light of public pressure for the FDA to approve a drug that treats obesity. The New York Times article (Can You Be Addicted to Foods?, January 5, 2011) outlining research that links alcoholism risk and obesity spurned some outrageous reader reactions, although this is not the first study to posit this connection. The results of this study may be of particular of interest to women, as it was found that this link was strongest among female study participants. It produced this correlation when participants were surveyed in 2000-2001, while no relationship existed ten years earlier in the 1990-1991 survey results.

The research suggests that the difference in ten years may be a consequence of the changing food environment in this country. The most widely available foods today are what David Kessler, former FDA commissioner referred to as “hyperpalatible” in his book “The End of Overeating”. Hyperpalatible foods include highly processed, sodium-entrenched and/or sugar soaked meals and snacks. These types of foods “trigger a neurological response that stimulates people to crave more food”, according to Kessler.

I don’t see why this is difficult to believe, although many readers are quick to deny. Highly processed foods-- including fast-food, microwave meals, toaster pastries, most items in a vending machine, instant coffee, etc, etc---have become the staples of a majority of Americans. First Lady Michelle Obama, as part of the developing “Let’s Move” initiative, intends to hold companies accountable for the clarity of their food labels. So far, results have been mild. Many companies argue that if they have to list sodium and sugar content clearly, than they should be able to boost the product credibility by emphasizing its “nutritious” aspects. As if fortified iron atones Lucky Charms.

Several hypotheses regarding the physiological mechanisms exist. One study published in the Journal of Neuroscience discovers that obese individuals have lower baseline levels of dopamine--- a neurotransmitter that helps control the brain's reward and pleasure centers--- and therefore overeat to compensate. Food intake is associated with dopamine release, as is alcohol consumption. When an individual consumes food (or alcohol and other drugs), dopamine is released. With fewer dopamine receptors, obese individuals need to consume more of the “rewarding substance” (food) to obtain the same effect as individuals with average receptor counts. The dopamine response weakens as the rate of consumption increases, thus enticing one to eat (or drink) even more to garner that nostalgic, pleasurable effect. In other words, an individual's tolerance for food is enhanced.

Another study by the Department of Psychiatry at the University of Florida College of Medicine & McKnight Brain Institute proposed the Salted Food Addiction Hypothesis, a theory that states that salted food acts in the brain like a mild opiate agonist, producing reward when consumed and withdrawal when salt intake is reduced. The original study did not specify the types of foods that many of us would consider rewarding, but I would make an educated guess that the most “rewarding” foods are of that highly processed variety---the chemical- enriched (high sodium) foods with the market power.

Companies can make calcium claims on their cookie boxes juxtaposed to the sugar warning in an effort to distract consumers from the illegitimate nutritional content. (It’s a cookie!) But this sends a confusing message. As a personal rule, I avoid buying foods with nutritional claims. Broccoli doesn’t scream its ingredients from across the grocery aisles. But isn’t this partly why the FDA exists (the F part)? To insure that the food on our shelves won’t kill us, but perhaps, nourish our bodies?
It is great to have choices when buy food. But do we really need a choice between actual food and Red #40 (banned in Denmark, Belgium, France, Germany, Switzerland, Sweden, Austria and Norway)? Perhaps if the regulating powers that be had as strong a sense of urgency to prevent an obesity epidemic as they do to treat it, this effort would be more collaborative.

So these food/drug analogies are not so far-reaching. Food addiction is not just a part of addiction rhetoric. Dismissing the validity of this research is only an additional disservice to the 2/3 of Americans who are currently overweight and obese, and the future 86% who are projected to be in 2030.

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