Ultra-processed foods, the tobacco of the 21st century?

Using the same criteria that were used to establish the addictive potential of cigarettes, researchers are proposing that ultra-processed industrial foods should also be considered addictive substances.

Ultra-processed foods, the tobacco of the 21st century?

Using the same criteria that were used to establish the addictive potential of cigarettes, researchers are proposing that ultra-processed industrial foods should also be considered addictive substances.

One of the great public health successes of recent years, but which is surprisingly little talked about, is the spectacular drop in smoking among young people. The exorbitant prices of tobacco, its banishment from public places and the emergence of alternative sources of nicotine such as electronic cigarettes have collectively caused the percentage of young people aged 15-19 who smoked cigarettes daily to drop from 30% to the late 1990s to just 3% in 2020.

This is extremely encouraging, especially since tobacco addiction usually starts very early, with 9 out of 10 smokers starting in adolescence.

In practice, this means that the next generation of adults will be largely made up of non-smokers and therefore much less affected by the health problems caused by smoking (lung cancer in particular) than previous generations.

DEPENDENCY CRITERIA

In 1988, the American Surgeon General published a report which showed beyond any doubt the addictive properties of tobacco (which were then denied by the tobacco companies).(1)

This report established that four criteria are sufficient to consider that a substance is addictive:

1) it causes compulsive consumption;

2) it exerts psychoactive effects;

3) it encourages repeat use; and

4) it creates strong cravings and feelings of lack.

This report marked a turning point in the fight against tobacco, because with the clear awareness for the first time of the addictive potential of cigarettes, the attitude of the public and the medical community towards the dangers of tobacco use was radicalized and resulted in a strong societal response to reduce the number of smokers.

ANOTHER FORM OF DEPENDENCE

A downside to the success of the radical reduction in smoking is that it was accompanied by a significant increase in the prevalence of overweight and obesity, so that the gains obtained in population health by the reduction in the number of smokers are counteracted by an increased risk of many diseases associated with excess fat.

The reasons for this significant increase in obesity are multiple and complex, but there is consensus that the consumption of ultra-processed foods (fast food, ubiquitous snacks, prepared foods), overloaded with fat, sugar and salt plays a very important role in this phenomenon.

Applying the same addiction criteria used for tobacco, researchers have recently proposed that overconsumption of ultra-processed foods may also lead to addiction to these substances.(2)

By examining all the studies that have looked at this question, the parallel between cigarettes and these foods is striking:

1) Compulsivity: It is well established that ultra-processed foods can cause excessive calorie intake, even though their disastrous effect on health is known to most people. An extreme example of this type of compulsion is the large proportion (20-50%) of people who have had bariatric surgery who persist in over-consuming these foods, even when they cause significant physical symptoms (nausea, cramps, vomiting) .

2) Psychoactive effects: It is known that all addictive substances activate the production of dopamine in the cerebral striatum. Studies show that the combination of sugar and fat found in ultra-processed foods causes a dopamine spike of a magnitude similar to nicotine.

3) Repeat consumption (reinforcement): Studies show that many people, both children and adults, repeatedly consume certain foods (chips, candies and cookies, for example) even when they are no longer hungry.

4) Cravings and cravings: Studies show that the foods that most frequently elicit cravings are all ultra-processed foods and that the areas of the brain involved in this phenomenon are similar to those of other addictive substances.

IS IT FOOD?

It is often said that food is essential to life and, therefore, we cannot equate drugs with what we eat.

This is to forget how ultra-processed foods are not foods in the usual sense. Rather, they are pure industrial creations, designed to quickly release abnormally high amounts of sugar, fat and salt in order to overstimulate our brains and encourage their repeated overconsumption, as the cigarette has been for the nicotine addiction.

Given this design, it's no wonder these products can be addictive.

(1) US Department of Health and Human Services (USDHHS). Health consequences of smoking: nicotine addiction. A report of the Surgeon General, 1988.

(2) Gearhardt AN et AG DiFeliceantonio. Highly processed foods can be considered addictive substances based on established scientific criteria. Addiction, publié le 9 novembre 2022.

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