From "concierge" services to iPads connecting new parents with their babies in the nursery, Kojo explores some of the patient-centered ideas coming from health care innovation labs at local hospitals.
A recent study links the addictive quality of Oreo cookies to that of cocaine. While researchers draw their conclusions from observing brain activity in rats, the study fits into a growing body of research that suggests foods high in fat and sugar can create actual addiction in people. Kojo looks at the science behind food addiction and explores how it could change our understanding of junk food culture.
- James Hamblin MD; Health Editor, the Atlantic
- Dana Smith researcher and PhD student, Behavioral and Clinical Neuroscience Institute, Cambridge University;
MR. KOJO NNAMDIDo you crave junk food? When you open a bag of salty chips do you feel a compulsion to eat them all? Do you feel symptoms of withdrawal if you go days without your favorite candy bar? Or are you back at the corner store just hours after you last bite? If your junk food habits sound more like a drug addiction, it may be the ingredients in the snack. According to new research in behavioral neuroscience, rats eating Oreos show similar neurological responses to rats injected with cocaine. It's just the latest study in a growing body of research exploring the addictive power of foods high in fat and sugar.
MR. KOJO NNAMDIAnd in a country where one-third of adults struggle with obesity, it could change how we think about our culture's attachment to junk food. Here to explain the science behind food addiction is James Hamblin. He's health editor at the Atlantic. He's also an M.D. James Hamblin, thank you for joining us.
DR. JAMES HAMBLINThank you for having me.
NNAMDIJoining us by phone from Cambridge, in the United Kingdom is Dana Smith. She is a researcher in the Behavioral and Clinical Neuroscience Institute at Cambridge University. Dana Smith, thank you for joining us.
MS. DANA SMITHThanks for having me.
NNAMDI800-433-8850 is the number to call if you'd like to participate in this Food Wednesday conversation. Do you think someone can be addicted to food like Oreo cookies in the same way as illicit drugs like cocaine? Give us a call, 800-433-8850. James, I'm sure many of us like Oreos and maybe we will eat a few in one sitting, but we probably wouldn't go as far as comparing the cookies to an addictive and illegal drug, but that's exactly what the study does. What makes the comparison between Oreos and cocaine work?
HAMBLINWell, I think it's definitely a disputed area, that not everyone agrees that calling this an addiction is an appropriate conclusion. It is a term that the researchers suggested in their paper, but it was a very small study. It was not peer reviewed. What happened was the term addiction kind of got thrown around very loosely in media coverage around this study. And I think that is where it really came into the conversation, people saying this is as addictive as cocaine, if not more, just because of the rats -- showed similar behavioral preferences for cocaine and for Oreos, as opposed to a control substance.
NNAMDIHow novel is it for a study to look at junk-food-urges through the lens of drug addiction, James?
HAMBLINIt has been done several times in the last few years. As we look at sort of parallels between the way people use drugs and the way food has become increasingly processed and oriented towards giving us this surge of blood sugar and dopamine that some people liken to the response of the reward stimulating our pleasure center in our brain, that you get from using a psychoactive drug.
NNAMDII guess because I've been in the media that’s been spreading this kind of either misinformation or information for a long time -- I remember when coffee used to be considered a possibly addictive substance.
HAMBLINRight. And they just released a new edition of the Diagnostic and Statistical Manual in Psychiatry this year. And that, for the first time, includes caffeine withdrawal, which is itself symptomatic of dependence on caffeine, which means if you don't have you experience physical symptoms, but addiction is usually defined separately. And that's not in the DSM and that will say that this dependence is pushing you to behaviors that are destructive. You are forgoing work or family obligations to get this substance. And that defines addiction for a lot of people.
NNAMDIDana Smith, many news sources picked up the study and ran headlines calling Oreos as addictive, or even more addictive, than cocaine. But you took to the Guardian this week to debunk that conclusion. Why do you think that particular claim is farfetched?
SMITHWell, my problem with the study was that they never actually compared how the rats reacted to cocaine with how they reacted to Oreos. They said the rats preferred Oreos over rice cakes. And they said they preferred cocaine over a saline injection, but they never actually compared how the rats -- which one they preferred, either Oreos or cocaine. So you can't actually say that one was preferred or more addictive than the other because they never actually did that comparison.
SMITHWhat they did show was that the rats had similar behavioral preferences for both Oreos and cocaine. And that they had similar brain reactions or they had increased activity in this reward center. But just because something is pleasurable or rewarding doesn't mean that it's addictive.
NNAMDIWhy -- can you explain exactly why researchers are singling out high-fat, high-sugar foods? What are they doing to our brains? And why don't we see the same response for whole grain or unprocessed foods, first you, Dana?
SMITHWell, it is true that foods that are high in fat and sugar do release a lot of the same pleasure chemicals, like dopamine and opioids, that drugs of abuse do. That's just the idea that something is pleasurable or enjoyable or rewarding for us. Things like talking to your friends, even going for a run, these release the same chemicals, as well. It's just something -- anything you enjoy is what can release these chemicals into your brain. But it is true that foods that are high in fat and sugar do this more than eating other foods.
SMITHNo one's going to claim that you can become addicted to broccoli for instance, because it just doesn't have that same affect on us. And there is evidence, also, that there can be some changes in your brain if you keep on eating these foods kind of consistently and that it can adapt, as it were, to not produce as much of these chemicals on it's own any more.
NNAMDISame question to you, James.
HAMBLINI think the value of comparing these foods to drugs is in orienting ourselves, as we look at our obesity epidemic -- in how we relate to our food. And starting to see that these junk foods -- or continuing to see that they are rewarding our brains and making us feel good, but, you know, they're not good for us. So it's the sort of thing that if you realize that's how your brain is being affected maybe you can be more aware of distancing yourself from that response.
NNAMDIOn to Joan, in Fairfax, Va. Joan, you're on the air. Go ahead, please.
JOANHi. Thanks of taking my call. I’m not sure I like this study either because when you talk about Oreos, there's a lot more in Oreos besides just fat and sugar. I know from my experience that anything that has a lot of glutamate in it causes me to, you know, really like it and I get a big pleasure boost and I can't stop eating the Doritos or whatever. And on top of that, a little bit later, like 20 minutes, it spikes your insulin on top of what a normal sugar response to insulin would make, so now I have all this extra insulin running around my body, so within 20 minutes I'm hungry again, and, you know, go back for another snack.
JOANAnd all that glutamate in your body causes other things, you know, acid reflux and it kills the B cells in your pancreas. So there's a lot of other things that are in Oreos and that are in all junk foods that create, you know, a bigger desire and possible addiction.
NNAMDIShould mention that the study we're referring to was conducted by Connecticut College, led by a neuroscientist name Dr. Joseph Schroeder. And that the results will be laid out at a neuroscience conference later this year. But, Dana Smith, to what extent is Joan correct, that there are other ingredients of the Oreo that may also be having an affect on our brains?
SMITHI mean, that is one possibility. I mean the ones that have been studied the most is certainly just kind of pure sugar and fat that we can look at and whether it, you know, kind of addictive or overly pleasurable or rewarding, but Joan is absolutely right that there are certainly other chemicals in Oreos and other types of junk food that a lot of the food companies put in because they're really looking for that right balance between fat and sugar. That kind of the most pleasurable for us. And they've done a lot of studies. They know what people want to eat and what will keep them coming back for more.
SMITHAnd these things are not necessarily good for your body. They're not going to find it in whole wheat grains and everything like that. So it is definitely a concern that other, more processed foods are -- there's something more in there than just the fat and sugar that is really kind of keeping you coming back for more.
NNAMDIJoan, thank you very much for your call. James Hamblin, some of us may eat an extra piece of candy when we know we shouldn't or head to the vending machine for a bag of chips when we do have a healthier snack on hand. We may feel guilty, but we wouldn't say we're addicted to junk food. How do scientists decide what makes it an addiction? You mentioned earlier some of the physical symptoms of withdrawal associated with, I guess, caffeine, associated with heroin and the like. Is that part of the difference?
HAMBLINPeople throw around the term addiction casually now to refer usually to what is traditionally defined as dependence. And for that to be an addiction it has to be interfering with your life. You know, you see this when someone is addicted to heroin. They're missing work. They're spending all their money, you know, in bad ways. They're driven to crime. These are the things that are immediately apparent.
HAMBLINThe thing that you don't see with more insidious things, like eating poorly, is that it's taken years for you to develop cardiovascular disease, increased risk for stroke, become slowly obese. So these are more subtle affects that are damaging to yourself, but that creates definitely a gray area that is certainly not as drastic or distinct in terms of what we normally think of as addiction.
NNAMDIDana, going cold turkey after being addicted to a drug like heroin can cause such a severe physical withdrawal that it can be deadly. Can food addiction ever cause that sort of physical dependency in a person?
SMITHNot as far as I'm aware of, no. The real kind of similarity that we make with the idea of food addiction is in binge-eating disorder. And that is actually a clinical disorder that's in the DSM 5 now, where people, you know, have some of those negative consequences that James is talking about, where they have a lot of regret and remorse and they continue eating even in the face of negative consequences like that. However, if you stop eating high-fat, high-sugar foods, you're not going to go through withdrawals. You're not going to have, you know, a physical dependency on these things.
SMITHOf course everybody needs to eat, you know, we're all relying on food for our natural energy, but there's a lot better ways to do it than through high-fat, high-sugar foods. And cutting those out of your diet or going cold turkey on them is not going to affect you negatively, in the same way that going off of heroin or alcohol will.
NNAMDIIt's a Food Wednesday conversation on the science behind what's alleged to be food addiction. We're inviting your calls at 800-433-8850. You can send email to email@example.com. Are there any foods that you feel a compulsion to eat? How would you explain our country's dependency on foods high in fat and sugar? 800-433-8850. You can send email to firstname.lastname@example.org or send us a tweet @kojoshow. Here's Jerry, in Laurel, Md. Jerry, you're on the air. Go ahead, please.
JERRYThank you, Kojo. Thanks for taking my call. I'm an ardent listener to your show. A great topic today. I wanted to stray a little if I can -- and please permit me -- when you're talking about food addiction, the first thing that comes to my mind is chicken. It seems to be one of the widest consumed foods globally. And I wonder if your researchers have any insight as to whether or not there's a parallel between the increased consumption of chicken and its obvious addictive properties.
JERRYI say addictive because I've been able to go without eating chicken for the last four years. And every time I see a sign, smell chicken or think of it, I immediately salivate and the urge to eat a piece of it is overwhelming.
JERRYIs there a parallel between addiction to food and chicken in particular?
NNAMDII don't know about chicken, Jerry. But on broadcast we've had before, I think goat is the meat that's consumed more than any other in the world today, it just doesn't happen to be so in this country. But I'll throw this one at you, James Hamblin, what do you know about this?
HAMBLINI don't know about chicken in particular. A lot of the chicken that we eat can be high in sodium, might come with something that is making it more like a junk food. But if it's, you know, a raw -- pure white chicken meat, this is very healthy for you, high in protein. So it shouldn't be any parallel between the sort of junk food studies that we're seeing today. And what you're describing is sort of Pavlovian conditioning response.
HAMBLINLike salivating at the idea of something that you like, which is again something that, you know, is a normal reaction and not necessarily indicative of this term addiction, which is detrimental to you.
NNAMDIDana, is it at all important that today's chickens that we are eating certainly in this country are all loaded up with all kinds of hormones?
SMITHI mean, I'm sure it's not helping. But, again, I have to go with James, I haven't really heard of a chicken addiction as it were. It might just be the prevalence of chicken. You know, it's so widely available. It's a lot cheaper than raw meat. So perhaps that kind of explains why it's so prevalent in our society today. As for the additives in it, I mean, again, I'm sure it's not helping anything. But I'm afraid I'm not actually a food scientist, so I cannot answer to that one.
NNAMDIJerry, I actually think what you have is known as love. Jerry, thank you very much for your call. We're going to take a short break. When we come back we'll continue our conversation on Food Wednesday, the science behind alleged food addiction and invite your calls at 800-433-8850. Or you can send email to email@example.com. Do you think the food industry or government have a responsibility to make foods healthier? Or should it be the individual's responsibility to pick healthy foods? 800-433-8850. I'm Kojo Nnamdi.
NNAMDIWelcome back to our conversation on whether or not food can be addictive. We're talking with Dana Smith. Dana Smith is a researcher in the Behavioral and Clinical Neuroscience Institute at Cambridge University. She joins us by phone. James Hamblin is an MD and health editor at the Atlantic. He joins us in studio. We're inviting you to join the conversation by calling 800-433-8850 or by sending email to firstname.lastname@example.org.
NNAMDIDana, this study makes conclusions about people by testing on rats. When it comes to neurological responses to food, how much do you know -- as far as you know -- do we really share with rats?
SMITHI mean, a rat is actually a great model for testing something that you can't actually do in human. So it's really commonly used if you're looking, especially in addiction research. You know, it's not really ethical to give people, you know, a dose of cocaine. But we can get really similar ideas of what would go on in our brains by looking at what happens in the brains of rats when we do get them drugs like that.
SMITHSo we know there's a lot of similar, you know, chemicals that go on and areas that light up. In the (unintelligible) which is a really common and old region of your brain that's involved in rewards. That's really kind of a center of a lot of addiction research.
NNAMDIJames, we might be able to observe that junk food is habit forming in people just by studying behavior. What more can we learn by finding out how it's affecting the brain? How does proving that junk food can be addicting in the brain change the debate?
HAMBLINWell, I think that changes the way that we think about it. If we are feeling that this is something that is an urge to be resisted, we understand how it's affecting our brains. We feel it's something that we can take control of, maybe it's empowering to understand this is doing the same thing for me, for my brain as it's giving me the same boost of dopamine that I get from talking to friends or doing some exercise and I can change the way I approach these sorts of urges.
NNAMDISame question to you, Dana.
SMITHI mean, I think it's really important in how we treat obesity. One idea of why food addiction is kind of put forward is that maybe by looking at this idea of obesity as an addiction, we can start treating it the same way that we do drug addiction. And maybe we should all be a little bit more sympathetic towards it seeing it as more of a disorder rather than just a lack of self-control that people have.
SMITHSo by knowing that there are actually changes in the brain that happen or there are, you know, similar facts in the brain that some foods can have like drugs then, you know, we can do a little bit more to actually target that and treat that rather than just (unintelligible) it's a lack of self-control.
NNAMDIOn to Toni in Washington, D.C. Toni, your turn.
TONIHi, Kojo, thanks for having me on. About 40 years ago, I was working on my own for the first time. And I lost an incredible amount of weight. When I went home again, I gained part of it back. And I wanted to sit down and figure out what was going on with that. So I found a book called "Sugar Blue" and I read it. And I was amazed. I don't know why people are so unwilling to jump on the topic of sugar.
TONIBut sugar is probably the most addictive, like, all the white powders in the world. And, you know, people avoid this as if their life is dependent on it. And that, you know, fats, we all need fat. You can't cut them all out. We love them. But if you cut down the sugar, things would be better. What's the comment on that?
NNAMDIJames, some people would add salt to that discussion.
HAMBLINYes. I think these are the three that are at the heart of the conversation right now. You know, we're thoroughly demonizing high fructose corn syrup. It's one of the things that everyone wants to take out of all their food. You know, we process corn and make sugar out of it because this country has so much of it. It's cheap, it's accessible. And it rewards our brains. So I think sugar is something that is definitely the heart of this whole carbohydrate craze and getting a lot of attention right now and that's good.
NNAMDIYou point out James some of the similarities in the social impact of junk food and drugs like cocaine. You write, for example, that they've both been abused among underprivileged populations. Could this kind of research give us a better understanding of junk food's place in American culture, if you will?
HAMBLINI think so. I think that's what's most interesting about it, is you see when a food cheap, cheaply produced, it's often not good for us and it becomes most accessible to populations that don't have, you know, fresh markets around the corner or people who just can't afford it. So they end up eating more of the processed food, more of the junk food with a lot of the sugar, fat, salt, preservatives and end up having incidences of diabetes and of obesity. And it hits those populations hardest.
NNAMDIThe Center of Disease Control finds about a third of adult Americans deal with obesity, kind of social justice issues that the science behind food addictions raise.
HAMBLINWell, if you have this lack of access for some people, even when you educate everyone how to eat well and people want to eat well and they simply don't have the methods to acquire that food and to meet those dietary requirements then it seems there needs some systematic change to give access to those resources that are needed to stem this epidemic.
NNAMDIDana, there are medical and psychological treatments for people dependent on all kinds of dangerous drugs. If research continues to suggest that certain kinds of food can create a drug-like addiction, how could that change how we treat eating disorders like binge eating or medical conditions like obesity?
SMITHYeah, that's a great question. You know, I think that currently how they treat eating disorders is mainly just with kind of psychological or therapy treatment. And what they're looking at right now in drug addiction research is actually using medicine to, you know, cut down people's cravings or to prevent withdrawal as well as to kind of prevent -- positive effects, if you take a drug and you have a medication in your system and you actually wouldn't have positive highs or effects of the drug itself.
SMITHAnd there is an idea right now that we could possibly make something like this for foods that are high in fat and sugar. There's an idea that you can play on the opioid system, which is what heroin commonly taps into and that we know foods high in fat and sugar also acts by kind of reducing your normal response to opioid-producing substances that maybe you actually wouldn't find food as pleasurable and maybe you wouldn't consume them as much or you would crave them last if you are really wanting that kind of sugar, fat fix.
NNAMDILet's talk with Christine in Ellicott City, MD about her experience. Christine, you're on the air. Go ahead please.
CHRISTINEHi, Kojo. Thank you so much for having me. I joined the conversation very late. But I just wanted to -- I just have a couple of things. I am, I guess for lack of a better word, a recovering food addict. I've dealt with this my entire life. I've been up and down. I've gained as much as 100 pounds. I'm very healthy right now, and at low weight. But food is definitely, I feel, especially sugar and refined carbs in addiction in the same way as alcohol and drugs.
CHRISTINEI'm not saying it as, you know, the immediate consequences are not be as bad. But long term they can be. And I joined the conversation when Ms. Smith was talking about, you know, the consequences of food addiction. And I know for me there was a time in my life where I was binge eating and exercising and I lost a significant amount of weight and then I, you know, I gained, like, 30 pounds in a very, very short, short period of time.
CHRISTINEAnd, you know, it does take an effect on your heart. Have some stuff in your heart and everything. And I do think it is similar in drugs and alcohol addiction in that every day you have to work on it. You know, when I wake up every morning, I have to think about and plan my day. And there are certain things that I do to ensure that I don't fall off the wagon again the same an alcoholic does.
NNAMDIChristine, I'm glad you raised that issue and thank you for your call. But keep listening because Holly in Washington, D.C. wants to offer a starkly different observation. Holly, it's your turn. Go ahead please.
HOLLYYes, hello. Thank you for having me. I just wanted to say that I used to binge eat myself and I went back to school to teach people that it's not really about the food, it's about our relationship with food. And there were so many people trying to categorize me as binge eating and emotional eating. And it wasn't until my body really broke down physically that I actually created a new relationship with food.
HOLLYAnd it was simply being mindful around these foods. And I was totally addicted to carbs and sugar. And it was -- I think the missing piece here is we can say healthy food all day long but it's not about whether it's healthy or not, it's about if it's about nutrient dense. So we're missing that. We can actually wean ourselves off the addiction of sugar and these foods that are really lacking nutrients when we start to pull in the nutrient-dense food that are whole and from natural sources and organic.
HOLLYAnd it doesn't have to feel like a soccer fight.
NNAMDIHolly, thank you very much for your call. Holly did not offer starkly different picture than our previous caller. But we did have a caller on the line who's no longer on the line. Kelly, who wanted to talk about the fact that drug addiction runs in her family and she finds it insulting that food issues would even be compared to the suffering and sickness that is drug addiction. What would you say to that, James Hamblin?
HAMBLINI say that's valid and very relevant. And at the same time, you see people who, by using this paradigm of looking at their relationship with food similar to a drug, you know, acknowledging that it's bad for them in large quantities, needing to regulate themselves and take control of it, that there are similarities in the way you can approach looking at that. Sort of -- maybe not so much like a hard drug-like heroin or cocaine but maybe more like alcohol where we think you can have a drink or two, you know, and that's okay. You can occasionally have some junk food. But you don't eat junk food all the time all day long. And it's the same with alcohol.
NNAMDIWell, Dana, the government has outlawed harmful and addictive drugs like heroin and cocaine. Do you think that research like this suggest that the government should, at the very least, be regulating how companies make snack foods like Oreos?
SMITHI think it is something to look at. You know, with the recent trying to pass the ban on large sodas in New York. You know, I think, that there is some sort of responsibility for the government to maybe, you know, regulate the food industry and what they're allowed to put into the food in terms of additives, maybe how high the sugar content or fat content can be in a certain amount of food.
SMITHBut, I mean, you do -- always to say that it is a personal choice. People should be free to make their own decisions on what they're going to put into your bodies. But, I think, there is at least a responsibility of the food industry to perhaps make these things a little bit safer. And I know that some have gone to steps to make that, you know, yogurt companies reducing the amount of sugar in the yogurt just because it's unnecessary, quite honestly. And I think even just kind of small changes like that could really improve the lives of some people.
NNAMDII'll end with a fairly long email we got from Catherine who says "I don't think it's addiction, I think it's deficiencies. I dieted for 39 years and never found a reasonable, helpful or satisfactory explanation for food cravings. I've never outlasted or overcome a craving. Food cravings are absolutely overwhelming. At one point, I will have to leave my desk, go to my car and drive to a store to buy the craved item."
NNAMDI"In 1998, I decided to go with cravings rather than fighting them. Over the next seven years, I lost 50 pounds and found that satisfying the craving sooner than later reduced the impact. Along the way, I discovered cravings for things like fish, spinach, broccoli, citrus, spinach, you get the idea. I believe, though I have no proof, that food cravings reflect deficiencies of some kind."
NNAMDI"Chocolate was easy. I was in physical pain. Spinach, iron, fish, who knows? In any case, I go with the cravings. And while they can be frightening, they do much less damage." I think I'll go with my father. Moderation in all things is what he used to say, James Hamblin.
NNAMDIJames Hamblin is an MD and health editor of the Atlantic. Thank you so much for joining us.
HAMBLINThank you very much for having me.
NNAMDIDana Smith is a researcher in the Behavioral and Clinical Neuroscience Institute at Cambridge University. Dana Smith, thank you for joining us.
SMITHThank you. It's great to talk with you.
NNAMDIAnd you all for listening. I'm Kojo Nnamdi.
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