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Food addiction, what if it's real?

While food addiction is not currently recognised as a clinical diagnosis, it is a concept that is gaining more attention in the scientific community. Some researchers argue that certain foods, particularly ultra-processed foods, can be addictive in the same way that drugs or alcohol can be. These foods often contain a high amount of sugar, fat, and salt, which can activate the reward centres in the brain and lead to addictive behaviour.

Studies have shown that food addiction can lead to weight gain, metabolic imbalances, and eating disorders. In people with eating disorders, the prevalence of food addiction is much higher, ranging from 48 to 100%. However, it is also possible to experience symptoms of food addiction without having an eating disorder or any other psychiatric issue.

In studies assessing food addiction in the general population, the most commonly reported symptom was a "persistent desire or repeated unsuccessful attempts to quit" certain foods. But the term addiction is probably too imprecise to be meaningful from a clinical perspective.

Not all foods are equally addictive, and some foods are more likely to lead to addictive behaviour than others. These foods are often referred to as "hyper-palatable," which means that they are highly pleasurable to eat and can activate the reward centres in the brain. Hyper-palatable foods often contain a high proportion of saturated fat, sugar, artificial flavours, or sodium, which can make them highly addictive. It is possible that a maladaptive eating is linked to the combination of macronutrients in palatable high-calorie food items that do not occur naturally, but that when combined can trigger a supra-physiological punch to brain motivation circuits that is sufficient to modify subsequent consummatory behaviours. A recent study in humans found that blended food items high in both fat and carbohydrate were more valued than palatable food items high in fat or carbohydrate alone, and that the blended food had a greater impact on the activity on brain areas involved in reward than the single-nutrient food items.

Currently, there are no evidence-based therapeutic guidelines for treating food addiction, and no clinical or laboratory exams that can be used as a definitive, diagnostic method.

Despite the lack of evidence, some healthcare providers and nutritionists often recommend carbohydrate restriction as a treatment for food addiction. This approach is based on the idea that limiting carbohydrate intake can reduce cravings and help individuals overcome their addiction to certain foods.

A study published in the journal Frontiers in Psychiatry investigated the effectiveness of a whole-food, low-carbohydrate diet combined with psychosocial support for the treatment of food addiction. This study included three small intervention programs in the United States, United Kingdom, and Sweden.

The results of the study showed that after 10-14 weeks of intervention, participants experienced significant reductions in food addiction symptoms and improvements in mental wellbeing. Interestingly, the body weight of participants was also significantly reduced, even though weight loss was not the focus of the intervention.

This study provides promising evidence for the use of a whole-food, low-carbohydrate diet combined with psychosocial support for the treatment of food addiction. However, more research is needed to confirm these findings and to determine the long-term effects of this approach.

As a nutritional professional, it is important to educate people, especially parents, about the dangers of hyper-palatable, processed foods and their potential role in the development of food addiction. Some practical suggestions for addressing food addiction include:

  • Following a low-carbohydrate diet, if tolerated, to reduce cravings and addictive behaviour.

  • Focusing on whole, unprocessed foods to provide essential nutrients and support healthy eating habits.

  • Avoiding "cheat days" or allowing yourself to indulge in addictive foods, as this can trigger cravings and undermine your efforts to overcome your addiction.

  • Avoiding artificial sweeteners, as these can trigger cravings and make it more difficult to break your addiction to sweet foods.

  • Remembering that weight loss is not the focus of treatment, but rather, the goal is to establish stable eating patterns and reduce cravings.

  • Being cautious with alcohol, nicotine, caffeine, nuts, and cheese/dairy, as these can trigger cravings and make it more difficult to overcome your addiction. If cravings persist, it may be necessary to eliminate these foods from your diet altogether.

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