Is sugar the new tobacco?

We owe our sweet tooths to the Arab world of the 7th and 8th centuries. It was in the newly founded Baghdad where people started our ongoing love of sweet treats, gorging themselves on sugar-based sherbets, honeyed porridge, fried syrupy pastries, and candies.

The word itself—“sugar”—comes from the Arabic “Sukkar“, which Europeans imported westwards, along with a sugary appetite, following the Crusades of the 11th century. Back then, sweets were infrequently enjoyed as treats: they were little pick-me-ups or remedies for a sleepy afternoon.

Now, sugar is everywhere—over 60 per cent of food and drink products in US supermarkets contain added-sugar, even in supposedly healthy foods, such as salads, soups, and granola.

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Reading food labels can set your teeth on edge. Coca-Cola in the US contains 10 grams of sugar. Even a can of tomato soup contains 7–8 teaspoons of sugar, which goes a long way to explain why the average North American consumes about 17 teaspoons of added-sugar every day.

This ubiquity of sugar is one of the biggest changes to modern diets around the world. Health experts blame sugar for common health concerns, including diabetes and obesity-related diseases.

Sugar overconsumption: A substance or behavioural addiction?

It can certainly feel like sugar is addictive. Binge-eating sweets, absconding followed by sugar craving, a feeling of withdrawal and rebound tiredness—they are all classical behavioural patterns associated with addiction.

Neuroscience studies show that chronic sugar overconsumption can change neuronal pathways in the brain, including alterations in dopamine signaling and changes in stress-related pathways. “These changes parallel those seen in substance use disorders and may contribute to the cycle of craving and overconsumption,” said Nicole Avena, a specialist in food addiction at Mount Sinai Morningside Hospital in New York, US.

But surprisingly, it is not clear whether sugar really is an addictive substance. Sugar does not directly act on the brain’s dopaminergic reward pathways in the same way that nicotine and cocaine do.

Some scientists hypothesise that sugar overconsumption may trigger food addiction by hijacking the dopaminergic reward system. Others consider that “only the pleasurable taste of sugary foods is responsible for addiction, not their high content of sugars,” said Octavian Vasiliu, a psychiatrist at Carol Davila University in Bucharest, Romania.

In other words, it might not be the sugar itself that is addictive, but rather the rewarding feeling it gives us when we eat it. This is different to highly addictive substances which directly act on the reward centres of the brain. That is why sugar overconsumption, like all food addictions more generally, is sometimes considered a behavioural addiction, rather than a substance addiction.

What causes sugar addiction?

“[Sugar] affects the brain in ways that can lead to unhealthy habits, especially in people who are stressed or have had challenging experiences early in life,” said Selena Bartlett and Kerri Gillespie, neuroscientists at Queensland University of Technology in Australia.

Bartlett and Gillespie told DW in a joint statement by email that it was important to understand why people fall into patterns of sugar overconsumption and addiction because “sugar consumption is deeply intertwined with emotional regulation”.

It is well established that emotional stress can cause the body to crave sweets—it can be the brain’s way to soothe depressive feelings. In the long term, depression and anxiety can indeed contribute to sugar cravings and potentially lead to a form of sugar addiction. “Research also highlights that early life stress can prime the brain to seek out hyper palatable foods like sugar,” said Bartlett and Gillespie.

Addicted or not, sugar is terrible for your health

Addictions are not necessarily bad—addictions are only problematic if the thing causing the addiction also causes harm. And long-term sugar overconsumption does cause harm.

The evidence is overwhelmingly clear that sugar overconsumption “is extremely dangerous for health”, regardless of any weight gain or not, said Vasiliu.

Scientists have been tracking the precise ways over-eating sugar changes how the body works for decades. Too much sugar—classified as over six teaspoons a day in women, nine in men—can lead to tooth decay, constant fatigue, diabetes, obesity, cardiovascular diseases, to name just a few health problems. High sugar diets are also linked with cancers and neurological disorders and dementia, such as Alzheimer’s Disease.

“One study found people who drank four or more soft drinks a week were twice as likely to feel depressed compared to those who drank less than one,” said Gillespie and Bartlett.

How to quit a sugar addiction

There are proven ways to wean yourself off sugar, but beating addiction requires a multi-pronged approach. Evidence-based strategies include behavioural interventions, such as cognitive-behavioural therapy (CBT), which helps individuals identify and modify patterns of compulsive behavior, including eating.

“Nutritional strategies, such as reducing added sugars gradually to avoid withdrawal-like symptoms, increasing protein and fiber intake to regulate blood sugar levels, and using structured meal planning, can also be effective,” said Avena.

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But very few people can beat sugar addiction on their own. Sugar has been described as “the new tobacco”. Vasiliu said it was crucial for governments to step in and “increase the availability of healthy food and decrease the excessive publicity of ultra-processed foods”.

Sugar taxes appear to be an effective way to deter people from buying sugary foods and drinks. A 33 per cent tax increase on sugary drinks in four US states saw a 33 per cent drop in soft drinks sales. People often find workarounds to taxes, however—a sugar tax on soft drinks was introduced in Mexico, but people just switched to fruit juices which were also had a high-sugar content but were not subject to the tax.

The UK government introduced a two-tiered sugar tax in 2018, which varied the tax on foods, depending on the amount of sugar in them. This led to manufacturers reducing the sugar content in their soft drinks, and overall consumption. But health experts say the effects of sugar taxes would be more powerful if the taxes were higher, and covered all types of high-sugar products, not just soft drinks.