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<\/p>\n

Some experts say carbohydrates should be treated like drugs or alcohol, but the science isn\u2019t clear-cut.<\/section>\n
\"Too <\/a><\/figure>\n

When Kerry Hammerton was offered a chocolate chip muffin at a yoga function, her peers were astonished by her response. \u201cI don\u2019t eat sugar,\u201d she told the waiter. \u201cI\u2019m a sugar addict.\u201d<\/p>\n

One of her yoga partners remarked: \u201cSurely one would be alright? You\u2019re not even fat.\u201d<\/p>\n

But Hammerton retorted: \u201cIf I was a cocaine addict, would you offer me cocaine and say it\u2019s okay to just have a little bit? It\u2019s exactly the same with sugar. If I have it, it will trigger my addiction.\u201d<\/p>\n

The yoga room flushed with surprise.\u00a0\u201cThey thought I was crazy,\u201d she recalls.<\/p>\n

Hammerton had been struggling with fluctuating weight for years. In April 2013 she began following a low-carb-high-fat lifestyle that required her to stop eating sugar and also drastically reduce her intake of foods containing other carbohydrates. \u201cEvery time I eat sugar, it makes me crave more of it. It drives my hunger,\u201d Hammerton says. \u201cSugar is addictive, like drugs are addictive.\u201d<\/p>\n

Cutting sugar is the \u201clong-term solution\u201d
\n<\/strong>Hammerton, who has lost 12kg since she began the new diet, is part of a growing movement of people trying to understand overeating, and the consequences of obesity, such\u00a0as diabetes and related heart problems, in terms of food addiction.<\/p>\n

One of the lobby\u2019s biggest proponents is sports scientist Tim Noakes.\u00a0 Last week Noakes co-hosted an international summit in Cape Town, the Old Mutual Health Convention, on low-carb-high-fat diets.<\/p>\n

On the website of Cape Town\u2019s Harmony Addictions Clinic, which treats obesity as a food addiction by getting patients to follow Noakes\u2019s low-carb-high-fat Banting diet, he proclaims: \u201cThe only long-term cure for obesity is to remove all addictive food choices [foods that contain sugar and other carbohydrates] from one\u2019s diet. There is no other long-term solution.\u201d<\/p>\n

According to Hammerton, her food cravings disappeared when she stopped eating sugar and carbohydrates. \u201cMy metabolism stabilized as a result of this diet,\u201d she argues.<\/p>\n

But the science of sugar and carbohydrate addiction is not nearly as simple.<\/p>\n

\"\"Mental order: Kerry Hammerton says she\u2019s a recovering sugar addict.<\/em><\/p>\n

Scientists are divided
\n<\/strong>The field of sugar and carbohydrate addiction is divided between those who believe sugar and carbohydrates are as addictive as, or in some cases even more addictive than drugs or alcohol, and those who say true addictions are limited to psychoactive substances that produce symptoms such\u00a0as physical intolerance and withdrawal.<\/p>\n

All carbohydrates are ultimately sugar; sugar is a type of carbohydrate with simple chemical structures. During digestion, complex carbohydrates, such\u00a0as those contained in food such\u00a0as potatoes, rice and bread, are broken down into the simple chemical structure called\u00a0glucose that the body uses as energy.<\/p>\n

Some public health experts, such\u00a0as Paul van der Velpen, who heads the Netherlands health department in Amsterdam, maintains that sugar is so harmful to our bodies that sugary products, particularly fizzy drinks, should be labelled with warnings such as those on cigarette packets. Such notices, he argues on the Dutch government\u2019s website, should caution that sugar is a \u201cdangerous addictive drug\u201d associated with obesity and diabetes.<\/p>\n

Last year, David Kessler, a former commissioner of the United States Food and Drug Administration, told the Mail & Guardian<\/em>: \u201cFifty years ago the tobacco industry, confronted with the evidence that smoking causes cancer, decided to deny the science and deceive the American public. Now we know that highly palatable foods \u00ad\u2013 [those with] sugar, fat, salt \u2013 reinforce and can activate the reward center of the brain. We quickly became trapped in a vicious cycle of dopamine-fueled urges when we want food and opioid releases when we eat.\u201d<\/p>\n

The \u201cdopamine-fueled urges\u201d that Kessler refers to are connected to \u201cfeelings of reward\u201d. Dopamine is a chemical, known as a neurotransmitter, in the brain that affects emotions, movements and sensations of pleasure and pain.<\/p>\n

Studies have shown that dopamine is the key player in the reward system \u2013 which gives us that feeling of pleasure \u2013 of the brain. When we eat something that tastes good, our dopamine levels rise, making us feel good and, some scientists argue, wanting more of it.<\/p>\n

Rise in obesity
\n<\/strong>A Lancet<\/em> study last year found that overweight and obesity rates among adults have increased by 27.5% over the past three decades worldwide. The study reported that South Africa was the fattest nation in sub-Saharan Africa.<\/p>\n

Researchers into sugar addiction have warned that the alarming rise of obesity has mirrored the use of high-fructose corn syrup as well a sharp increase in general sugar intake. High-fructose corn syrup is a liquid sweetener introduced in the late 1970s to enhance the taste of cereals, processed foods and soft drinks; it is found in most of those products in the US and consists of extremely high percentages of fructose, a type of simple sugar that is roughly 1.2 times as sweet as table sugar, according to the American Dietetic Association. In South Africa, however, sucrose derived from cane sugar is used more commonly as sweetener than high-fructose corn syrup.<\/p>\n

A 2011 study, published in the journal Front Psychiatry<\/em>, estimates that about 10-20% of people would present with addiction-like symptoms toward hyper palatable [with high amounts of sugar] foods. According to a 2014 review of sugar addiction studies in the Clinical Nutrition and Metabolic Care, this proportion is similar to the proportion of \u201ccocaine or heroin users who go on to develop addiction\u201d.<\/p>\n

Not recognized as an addiction
\n<\/strong>But sugar and carbohydrate addiction is not recognized as an addiction in the \u201crule book\u201d that most psychiatrists use to diagnose mental disorders: although the latest edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM) includes binge eating disorder as a psychiatric illness, it does not acknowledge it as an addiction. Binge eating disorder also does not apply\u00a0to everyday overeating, but rather to a specific condition in which unusually large amounts of food are consumed in relatively short periods at least once a week over a period of three months.<\/p>\n

The authors of the DSM, the American Psychiatric Association, only include conditions when they consider the available evidence for such\u00a0illnesses to be conclusive.<\/p>\n

Noakes argues that sugar and other carbohydrates make you hungry, so you overeat. \u201cThey do not satiate you and drive your appetite \u2026 Sugar, probably more than other carbs, drives that hunger and has fueled, if not caused, the world\u2019s obesity epidemic.\u201d<\/p>\n

But many of his peers have been highly critical of him for this.<\/p>\n

\"\"<\/p>\n

No single nutrient to blame
\n<\/strong>In August 2014 Cape Town anesthetist Luc Evenepoel, who published the diet book Dr Luc\u2019s Promise \u2013 Lose the Weight and keep\u00a0it Off (2012), warned in a letter published in the Star<\/em>: \u201cTo blame one single group of molecules [carbohydrates] for two such\u00a0mind-bogglingly complex problems [obesity and diabetes] is like saying that global warming is solely caused by the bowel gas of livestock.\u201d<\/p>\n

Stellenbosch University dietician Celeste Naud\u00e9 agrees: \u201cTo demonize any single nutrient in isolation is not helpful. Yes, the load of added sugar in our food system is a big part of the problem, as are added fat and sodium [salt].<\/p>\n

\u201cBut we should focus more on the quality of the foods and drinks we consume and less on blaming single nutrients \u2013 sugar-sweetened beverages are not the same as lentils, although both contain sugar and carbohydrates. The health effects of sugar added to foods and drinks during manufacturing are not the same as the sugar and carbohydrates occurring in fresh, whole foods such\u00a0as milk and fruit.\u201d<\/p>\n

Several studies on rats have confirmed that sugar stimulates the same pleasure centers in the brain as psychoactive drugs or alcohol. One such\u00a0study, published in the journal Neuroscience & Behavioral Reviews<\/em> in 2008, found that, after a month of an intermittent sugar feeding schedule, the rodents showed \u201ca series of behaviors similar to the effects of drug abuse\u201d, such as binging, withdrawal and craving.<\/p>\n

But critics have cautioned that the results of studies such as this one aren\u2019t necessarily applicable to humans, as they analyses the behavior of rats in controlled environments rather than that of humans in everyday living environments, in which a series of additional factors, such as personality, values, tastes and preferences, will influence people\u2019s intake of sugar.<\/p>\n

Sugar is a \u201chazard\u201d
\n<\/strong>Some researchers, such\u00a0as the authors of a study published in a 2013 study in Biological Psychiatry<\/em>, argue that the ready availability and affordability of foods with high amounts of added sugar have turned sugar into a \u201cserious modern hazard to public health\u201d.<\/p>\n

In a meta-analysis study, which reviewed 68 studies on sugar intake and its relationship to weight, researchers found that the more sugary foods participants consumed, the fatter they got, and the less, the thinner they became.<\/p>\n

The study, which was published in the British Medical Journal<\/em> in 2014, concluded that, \u201cwhen considering the rapid weight gain that occurs after an increased intake of sugars, it seems reasonable to conclude that advice relating to sugar intake is a relevant component of a strategy to reduce the high risk of obesity in countries\u201d.<\/p>\n

But this study also stated that \u201cisoenergetic replacement of sugars with other carbohydrates [that is, equal kilo calories in the diet from other carbohydrates] did not result in any change in body weight\u201d.<\/p>\n

A balanced diet may be the solution
\n<\/strong>According to Naud\u00e9, this finding demonstrates that total kilo calories fundamentally drives weight gain.<\/p>\n

\u201cThe long-term solution to weight loss is not necessarily to cut carbs entirely from your diet, but rather to pay attention to your total kilo calorie intake and the foods you choose to eat,\u201d says Naud\u00e9. \u201cDifferent diets work for different people. The most important thing is to find what helps you keep your energy intake in check and to make quality food choices for good nutrition. Steering clear of aggressively marketed, ultra processed, highly palatable, energy-dense foods, loaded with added fat, sugar and sodium (such as junk food: fast foods, chips, pastries, chocolates and fizzy drinks), is half the battle won.\u201d<\/p>\n

Research that Naud\u00e9 and her colleagues at the Center for Evidence-based Health Care at Stellenbosch University conducted last year, in which the results of 19 clinical trials were pooled, found that low-carb-high-fat diets did not result in more weight loss than traditional balanced diets in the long term when kilo calories in the diets were equal.<\/p>\n

A 2012 study in the Nutrition Journal<\/em>, which followed the self-reported food and nutrient intake and measured body weight of 14\u00a0000 Swedish men and women over a period of 25 years, had similar results: it found that a low-carb-high-fat diet, which contains significantly less sugar than balanced diets, was not associated with less body fat.<\/p>\n

\"\"<\/p>\n

Sugar tax
\n<\/strong>In South Africa, a growing number of health experts and consumer bodies have been calling for a sugar tax of 20% on products that contain high amounts of added sugar, such\u00a0as soft drinks, as a way to curb South Africa\u2019s increasing obesity levels. As a result, a sugar tax is being considered by the health department.<\/p>\n

The University of the Witwatersrand has reported that a 20% tax on sugar-sweetened beverages could lead to more than 220?000 fewer cases of adult obesity in the country. South Africans drink large amounts of sugar-sweetened beverages: In 2010, intake was almost three times greater than the global average, according to Naud\u00e9. Reducing the intake of sugar-sweetened beverages is seen as one strategy that could help\u00a0reduce kilo calorie intake and obesity.<\/p>\n

Does that mean sugar is addictive, and if so, to the same extent as drugs and alcohol?<\/p>\n

Is sugar addiction real?
\n<\/strong>Not necessarily, say the authors of the Clinical Nutrition and Metabolic Care review: while there is evidence in non-humans \u2013 mainly rats \u2013 that foods high in sugar can induce reward and craving responses that are at least comparable to those of addictive drugs, this has not been proven conclusively in humans.<\/p>\n

\u201cIn most cases \u2026 the experienced psychoactive effects of sweet foods is mild and does not seem to match those of drugs,\u201d the authors conclude. \u201cIn other words: sweet foods are clearly not as behaviorally and psychologically toxic as drugs of abuse can be at high doses.<\/p>\n

\u201cFor instance, unlike drugs, consumption of hyper palatable foods, even [when] extremely high in sugar, does not produce any abnormal mental state or change in behavioral disposition.<\/p>\n

\u201cThis explains why no police officer will arrest a driver because he or she had eaten several doughnuts before driving the car or why no judge will consider drinking half a gallon of sugar-sweetened\u00a0soda before committing a crime as a mitigating circumstance.\u201d<\/p>\n

\n

Stuck on the sweet, sweet road to obesity and self-loathing<\/h1>\n

On a Wednesday night in April 2013, Tania Bosman (23) arrived at her brother\u2019s house in Brackenfell, near Cape Town, with all his favorite snacks \u2013 Simba and Doritos chips, Zoo biscuits and Salticrax.<\/p>\n

\u201cI wanted to spoil him because he had broken his foot \u2026 the day before,\u201d she recalls. Bosman arranged the nibbles on a few plates on the kitchen counter and positioned herself next to them. She started to eat. And eat. And eat?… she just couldn\u2019t stop.<\/p>\n

Soon, Bosman, who weighed 145kg at the time, realized she was eating far more than her brother and his friends. She felt embarrassed and stopped.<\/p>\n

It wasn\u2019t the first time. At work Bosman would hide snacks in her drawer. \u201cI would only eat in front of people if it was healthy foods because I didn\u2019t want them to know I was eating chocolates. Obviously you could see that I had an eating problem \u2013 I was enormous \u2013 but I tried to hide it as much as possible.\u201d<\/p>\n

But on that April evening at her brother\u2019s house, one of his friends, who had just been released from a drug rehabilitation center, started to talk about his drug addiction. \u201cAs I was listening, I thought, maybe I have a similar problem with eating. So many of the emotions he experienced with drugs, I experienced with food: cravings, binges and withdrawal symptoms,\u201d she recalls.<\/p>\n

When she got home, Bosman googled \u201cfood addiction\u201d. She stumbled on to the Harmony Addictions Clinic in Hout Bay\u2019s website.<\/p>\n

There she found the \u201cHarmony Eating and Lifestyle Programme (Help)\u201d. \u201cDo you find carbohydrates and sweet fatty foods difficult to manage in moderation, often leading to overeating and binge eating?\u201d a question on the programme\u2019s website asked. \u201cDo you experience guilt or shame due to your eating behavior?\u201d And finally: \u201cDo you feel better after eating sweet foods or feel withdrawal when trying to cut these out of your diet?\u201d If so, according to the website, you might be addicted to carbohydrates and sugar.<\/p>\n

\"\"Tania Bosman\u00a0<\/em>has lost 37kg on the low-carb-high-fat diet.<\/em><\/p>\n

The next afternoon, Bosman enrolled herself in an eight-week carbohydrate and sugar addiction treatment programme as an outpatient at the clinic. \u201cWhile I discovered that, emotionally, I eat to suppress my feelings, I also learned that the carbs \u2013 and sugar is a carb as well \u2013 made me crazy. It made me moody and depressed but, most importantly, constantly hungry.<\/p>\n

\u201cIt became very easy to accept I was a sugar and carb addict, because it made sense.\u201d<\/p>\n

Help dieticians put Bosman on sport scientist Tim Noakes\u2019s low-carb-high-fat diet, known as Banting. It contains unusually low amounts of carbohydrates and sugar. She lost 37kg over the past 22 months \u2013 the longest that she\u2019s maintained weight loss on a diet.<\/p>\n

\u201cIt curbed my hunger,\u201d Bosman says. \u201cI used to eat three to four slices of bread [which is high in carbohydrates] when I woke up for breakfast. \u201cBy 10am I was starving and I wanted something else. It was always bread, crisps, chocolates or pies \u2013 that kind of stuff \u2013 that I would then start to binge on. \u201cBut now I have a high-fat breakfast of egg and bacon, and I can go for five, six, sometimes even seven hours without eating again, because I\u2019m legitimately not hungry. This is what works for me.\u201d<\/p>\n

\n

Just two spoonfuls\u00a0of sugar \u2026<\/h1>\n

Sugar should make up less than 10% of our daily energy intake, according to the World Health Organizations (WHO) draft guidelines. That works out to about 50g or 12 teaspoons of sugar for a person of normal weight.<\/p>\n

The WHO further recommends that a reduction to below 5% (six teaspoons) would have additional benefits for dental health.<\/p>\n

A 2012 study published in the British Medical Journal<\/em> reported that South Africans consume an average of 84g, of sugar a day \u2013 far more than what is good for us.<\/p>\n

Much of the sugars consumed today are \u201chidden\u201d in processed foods that are not usually seen as sweets. According to the WHO, one tablespoon of tomato sauce contains about four grams, or one teaspoon, of sugar.<\/p>\n

A 500ml bottle of sugar-sweetened soda, such as a Coke, has 40g, or 10 teaspoons, of sugar \u2013 almost the entire recommended daily sugar allowance. Up to half of grade eight to 10 pupils in South Africa in 2008 were reported to be consuming fast foods, cakes and biscuits, cool drinks and sweets at least four days a week, according to Stellenbosch University dietician Celeste Naud\u00e9.<\/p>\n

\"\"<\/p>\n

This is the second part in\u00a0a two-part series on sugar\u00a0and carbohydrate addiction\u00a0<\/em>and low-carb-high-fat diets<\/em><\/p>\n

 <\/p>\n

276.02.2015 M&G Ria Malan<\/p>\n","protected":false},"excerpt":{"rendered":"

Some experts say carbohydrates should be treated like drugs or alcohol, but the science isn\u2019t clear-cut. When Kerry Hammerton was offered a chocolate chip muffin at a yoga function, her peers were astonished by her response. \u201cI don\u2019t eat sugar,\u201d…<\/span><\/p>\n

Read more ›<\/a><\/div>\n

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