Posted on Oct 12, 2023, 7 p.m.
In collaboration, a group of international and multidisciplinary researchers with expertise in food addiction, nutrition physiology, food policy, eating disorders, behavioral addiction, and gut-brain reward signaling, have published an analysis in a special edition of the British Medical Journal Food For Thought, with a “controversial” recommendation: “It's time for an international shift in the way we think about ultra-processed food.” The team calls for more research on the science surrounding ultra-processed foods.
"There is converging and consistent support for the validity and clinical relevance of food addiction," said Ashley Gearhardt, the article's corresponding author and a psychology professor at the University of Michigan. "By acknowledging that certain types of processed foods have the properties of addictive substances, we may be able to help improve global health."
Most people can eventually give up addictive habits like smoking, gambling, drinking, or drugs, but they can’t stop eating. Not all food is healthy, and a growing mountain of evidence shows this. However, the challenge, and opening of the debate, is defining which foods have the most potential for addiction and why. Not all foods have the potential for addiction, but some have way more potential than others, and some, here comes the controversy, such as ultra-processed foods, even appear to be designed that way.
"Most foods that we think of as natural, or minimally processed, provide energy in the form of carbohydrate or fat -- but not both," said co-author Alexandra DiFeliceantonio, assistant professor at the Fralin Biomedical Research Institute, and associate director of the Fralin Biomedical Research Institute's Center for Health Behaviors Research and an assistant professor in the Department of Human Nutrition, Foods, and Exercise in the College of Agriculture and Life Sciences at Virginia Tech.
For example, compare an apple, salmon, and chocolate bar. The apple has a carbohydrate-to-fat ratio of around 1 to 0, the salmon has a ratio of 0 to 1, and the chocolate bar has a ratio of 1 to 1, which appears to increase the food’s addictive potential, according to the researchers.
"Many ultra-processed foods have higher levels of both. That combination has a different effect on the brain," DiFeliceantonio said. Researchers also called for more study into the role of food additives used in industrial processing.
The researchers found that behaviors around ultra-processed foods that are high in refined carbohydrates and fat may meet the criteria for diagnosis of substance use disorder in some people. These behaviors include but are not limited to less control over food intake, intense cravings, symptoms of withdrawal, and continued use despite consequences such as obesity, binge eating disorder, poorer mental and physical health, and a lower quality of life.
A review of 281 studies across 36 different countries found that ultra-processed food addiction occurs in 14% of adults and 12% of children. However, in some countries, these food choices are a needed source of calories, such as in places with limited access to food, and food deserts prevent access to minimally processed foods. Food insecurity makes people more reliant on ultra-processed foods, and more likely to demonstrate food addiction.
The researchers suggest that viewing some foods as being addictive could lead to approaches in the realm of social justice, clinical care, and public policy. Policies already implemented in some countries (Chile, Mexico, and the United Kingdom) such as taxes, labeling, and marketing are associated with decreases in caloric intake and purchases of foods that are high in sugar, salt, and saturated fats.
"Given how prevalent these foods are -- they make up 58 percent of calories consumed in the United States -- there is so much we don't know." DiFeliceantonio said.
More study is needed into such areas as: how complex features of ultra-processed foods combine to increase their addictive potential; better defining which foods can be considered addictive; differences among countries and communities, including disadvantaged communities; the value of public-health messaging; and clinical guidelines for preventing, treating, and managing addiction to ultra-processed foods.
As with anything you read on the internet, this article should not be construed as medical advice; please talk to your doctor or primary care provider before changing your wellness routine. This article is not intended to provide a medical diagnosis, recommendation, treatment, or endorsement.
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