Presentation overview:

Dr Robert Lustig is an emeritus professor of pediatrics in the Division of Endocrinology and a member of the Institute for Health Policy Studies at the University of California San Francisco (UCSF). In this lecture, he explores whether food addiction is real, and builds a case for food additives (sugar in particular), rather than food per se, being addictive.

Learning objectives:

• Learn which components of ultra-processed food may be addictive
• Understand the neuro-endocrine mechanisms behind sugar addiction and become familiar with the evidence that supports these
• Become familiar with the definition of addiction and how “food”, “food additives” or sugar measures up
• Become familiar with the semantics and related arguments around the term “food” addiction and their implications
• Understand how the food environment has changed over time and the implications for “food addiction”
  

Presentation summary:

Dr Lustig begins this lecture by exploring the evolution of the concept of food addiction, which began appearing in scientific journals in 2009. He emphasises the importance of identifying what aspect(s) may be responsible for the addictive nature of some foods, in order to know what aspect of food or the food environment to change.

Dr Lustig builds the case that the only addictive items in processed food are sugar and caffeine but that they aren't really food at all; they’re food additives. Fat and salt increase the ‘salience’ or ‘tastiness’ of food but are not themselves addictive. Dr Lustig describes the biochemical pathways and presents literature showing that sugar increases insulin, inhibiting leptin signalling, which indirectly inhibits the extinguishing of reward. He also shows how sugar directly stimulates the nucleus accumbens (reward centre).

Dr Lustig argues that just because something has calories in it doesn’t make it a food; it could be a food additive (e.g. ethanol, trans-fats). He says food addiction is a misnomer; it’s really “food additive” addiction - the primary one being sugar. “Sugar is the payload, ultra-processed food is the vehicle”. Sugar is described as the driver of chronic metabolic disease, morbidity mortality and climate change. He ends off by saying that ultra-processed food is toxic, addictive and ready for regulation.

Downloadable resources:

1. Presentation
2. Reference list