Addicted to “Food Addiction”

I recently wrote a short article on “food addiction” for the Risk Innovation Lab’s CrisBits blog (collaboratively published by Arizona State and Michigan University!). This piece mainly focuses on the scientific side of the issue- I really wanted to broadly cover research on the topic, since so many popular articles on food addiction focus on singular studies (and end up being extremely misleading). Yet I also really wanted to address the topic from an anthropological perspective.

… the notion of addictive foods attracts us on a much deeper level as well

So why are we.. almost addicted to the belief that “food addiction” is a thing? If you read my CrisBits article, you’ll see that there is (as of now) no actual evidence for any food ingredients causing addictive-like responses in humans. The field is highly debated, though: there’s plenty of scholars arguing pro and against. On top of that, the media often does a horrible job sensationalizing food addiction research (well, I suppose it does a great job sensationalizing, but a horrible job communicating the results correctly). All of that can surely create the illusion that science actually supports the food addiction theory. However, the notion of addictive foods attracts us on a much deeper level as well…

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The allure of addictive foods

There is a strong cultural appeal in the idea that certain “bad” foods or their components can cause dependence and are thus dangerous (e.g. MSG, casein, gluten). This view of overeating as addiction includes the need to “detox” and instead eat a “clean” diet (e.g. this: The Diary of a Sugar Addict in Detox).

These are not just modern health trends, but a manifestation of a need to understand our world by imposing structure and thus meaning on the untidy experience that is reality. Structure is created by categorizing things into clean/unclean, healthy/unhealthy, pure/dirty- and things that don’t clearly fit into such categories are considered unclean and dangerous. Anthropologist Mary Douglas makes this point in her seminal book, Purity and Danger, as she examines food taboos (cultural rules about what not to eat). Douglas points that prohibited foods are considered “polluting” because they defy easy classification into culturally important categories. The current unease with genetically engineered foods is a fantastic modern example: as a technology that blurs the lines between natural and unnatural domains, it is indeed often termed by opponents as “genetic pollution” or “contamination”.

…prohibited foods are considered “polluting” because they defy easy classification into culturally important categories.

The categories we create to make sense of the world have strong moral overtones, as they allow us to essentially define right and wrong. Indeed, the word “addiction” itself is connected to the moral disapproval of socially undesirable behaviors (e.g. drug abuse). Psychologist Paul Rozin points out how the fear of sugars in American diets, for example, reflects the Puritan belief that things that are very pleasurable must also be bad.

Religious Scholar Alan Levinovitz also emphasizes that people frame eating in terms of morality and religion. He discusses how concepts of healthiness reflect the “myth of paradise past”- the idealistic belief that things were better, healthier, and even morally superior before. From such perspective, novel changes to foods represent our fall from grace- whether via agriculture (e.g. as in paleo diet ideology) or industrialization and technology (as with processed and genetically modified foods).

So, that’s my little anthropological view of food addiction beliefs as a cultural phenomenon. Hope you enjoyed it!


P.S. You might see news reports on studies about food addiction.. but keep in mind that no clinical diagnosis for “food addiction” exists, and most such research uses a self-report questionnaire: the Yale Food Addiction Scale (YFAS). This tool uses DSM-IV’s generic criteria for substance abuse to measure addictive-like eating.

Most importantly, it does not validate the existence of “food addiction” as a true disorder (DSM diagnostic criteria is intended for trained clinicians, not a checklist for self-diagnosis via a simple questionnaire). This is a critical issue to consider, as most food addiction research with humans is based on diagnosing food addiction this way.

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Time of Eating & Health: Video

I made my first science communication video! It took me only ~ 15 hours, no big deal 🙂

It won’t be as time consuming from now on..but there is a lot of work involved nevertheless: writing a good concise script, sketching all the images that could go along with it, setting up the recording (can be so tricky!), recording yourself draw (and redraw.. and redraw) every frame.. Then editing all those videos, recording the audio (and re-recording..and re-recording again), and finally matching video to audio (as well as finding some free background tunes to go along!). Check it out: 

 

I chose this topic because i’ve been craving to cover it for some time now. Since my dissertation work focused on lay models of healthy eating across cultures (so: people’s beliefs about what it means to eat well), I did not address the scientific accuracy of any perceptions. But oh I wanted to! And that is because one of the most fascinating findings from my interviews was that eastern European (EE) participants considered “how you eat” (i call these “eating styles”) to be more important for health than American respondents.

Eastern Europeans (EE) judged statements about EATING STYLES (such as time of eating) as more important for health…

Specifically, EE participants rated the statement “it is important to avoid eating late in the day” significantly higher than Americans (and this was true from my past survey-based studies!).

This is what the image below shows, but let me explain the method behind it: I conducted >70 interviews in the U.S., Romania, and Ukraine where I asked people to look at 42 different statements about “healthy eating”. Among other activities, they had to indicate how much they personally agreed with each statement (from “4” agree completely to “-4” disagree completely; I used Q Methodology for this, by the way ).

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So, between Americans and eastern Europeans, 1 statement about eating styles (or “context” as I referred to it in this chart) that was more important for the latter: not eating late.

So, out of ALL 42 cards, only “avoid eating late in the day” got a statistically significantly higher agreement score from eastern Europeans. AND when prompted to explain their views, my respondents gave an explanation that was amazingly close to the actual science of circadian rhythms!!

Why did EE folks seem to know about circadian rhythms way more than Americans?

I didn’t analyze why EE folks seem to know about circadian rhythms way more than Americans, but this knowledge is something they knew from childhood.. It was part of general recommendations and “common sense” while growing up in the USSR. It fact, importance of eating styles is prominent in traditional beliefs about health (like in Japan and China).. perhaps all the focus on nutrients that’s possible with modern science is taking our attention away from this old wisdom?

perhaps all the focus on nutrients that’s possible with modern science is taking our attention away from this old wisdom

Now that nutrition science is paying increasingly more attention to eating styles as well (CHRONO-NUTRITION!), I assume American folks will begin incorporating beliefs about importance of food timing also!

Healthy Eating- Real or Imaginable??

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The lobby of one of the conference hotels during non-busy time. The hallways were overflowing with anthropologists all over the world just hours later 😀

This December I presented on my research at the American Anthropological Association in D.C. (woohoo!) What a blast! The conference was bursting with anthropologists all over the globe; the 5-day event was so packed with presentations that the program which included just names of talks & authors ran about 500 pages.

Anyway, one of the interesting moments from the trip was a scholar (I believe she did some work in Latin America but I don’t know what kind of anthropologist she was), who was seemingly bothered by our session on food and nutrition. Our talks focused on “healthy eating” as a social construct [a social phenomenon created and developed by society; a perception or idea that is ‘constructed’ through cultural or social practice]. My talk was on how perceptions of what healthy eating means differs among and within cultures (Ukrainians & Americans in my study), while other presenters talked about how food is discussed in the Canadian Arctic and among those following a traditional “paleo” diet plan. 

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Presenting on my Ukrainian study!

The question this lady asked was why we spoke of healthy eating as something created and perceived by humans as if there is no objective healthy diet supported by science.

It’s a bit funny to hear someone being surprised that concepts are discussed as a social creation vs. an objective reality at an anthropology meeting.. but that shows how food and healthy eating can be quite emotional when one is health conscious! I would bet this scholar was someone who personally cares about eating well for her own health. Understandable. Food is a very emotional topic- it is not only good/bad for health and looks, it also represents our identity, our culture, our experiences, etc.

Part of my answer to her was that science might not be able to give her what she is looking for- the objective healthy diet. Not because science sucks, but because nutrition studies are lengthy, complicated, and costly (see my post on why nutrition science doesn’t suck HERE). My favorite example of why nutrition science is hard to rely on is SUGAR. Look at this World Health Organization 2003 report (see full report).

The common sense might tell you that added sugar can’t be good- it adds calories, maybe it makes you hungrier or disrupts bodily processes, maybe it’s just unnatural. People I interview often mention that sugar is one of the main causes of weight gain. Common sense, right? Well, look at the WHO report and check out Free Sugars (= all monosaccharides and disaccharides added to foods by the manufacturer, cook or consumer, plus sugars naturally present in honey, syrups and fruit juices). The only convincing evidence from scientific studies is that free sugars increase the risk of dental caries. Not weight gain, not diabetes, not heart disease. Does this mean sugar is only bad for teeth? No, it means there isn’t evidence that it causes other disease with the studies that we have. So if you want to state with complete confidence that added sugars lead to chronic disease and obesity, you might have a hard time backing it up.

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Thinking that there is no such thing as a healthy diet is unsettling. We want clarity. :S Saying that “healthy eating” is an idea constructed socially, however, doesn’t mean that there is no such thing as healthy eating. It does mean that there are multiple ways one can eat well to avoid disease- it can be vegetarian, vegan, paleo, regular calorie restricted diet, Mediterranean diet, etc. etc. etc.

Historical perspective on what good/healthy eating is.

The official stance on a healthy diet is not purely unbiased either- the political and historical context shapes what is officially recognized.  I heard a very interesting talk on the differences in nutrition perceptions between Denmark and Germany during 1940-1945 by Dr. Jensen (University of Copenhagen). She talked how in the early 20th century macronutrients, salts, water and ash were believed to be the sole constituents of food.  Then vitamins were discovered resulting in growing scientific interest in identifying new “micronutrients”, a development that altered (diminished) the perceived importance of the macronutrients (protein, fat, carbs).  So as in Denmark micronutrients became the focus, good nutrition became about vegetables- the source of many micronutrients. In Germany, however, a country experiencing hunger during WWII, macronutrients remained as most important considerations in nutrition textbooks (with protein considered the primary element of food- for the satiety and strength it provides, especially for a country at war!). The point is- the scientific (and thus public) perceptions of what good eating means is shaped by societal circumstances.

It all just depends…

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Baklava- a middle-eastern dessert I am absolutely insane about. My friends sometimes wonder how I can study health yet eat something so “unhealthy” as a high sugared dessert. IS it unhealthy? Turkish people love their sweets, yet traveling around Turkey will show you that the population is not plagued by obesity and chronic disease.

Back to whether an objective healthy diet exists or not. If we ignore for a second that people disagree on the details of what one should eat to stay healthy (is carb or fat evil? is animal protein toxic? should you go vegan? avoid gluten like the plague?), most folks at the minimum agree that eating “real” or whole foods is important (or in other words- avoiding or limiting modern processed foods and focusing on the less modified foods). I suppose we could say that this definition of a healthy diet is generally accepted. If we move on from processed vs. whole, though, here are a couple of examples of when something generally healthy might not be good for you or vice versa:

Cabbage! A wonderful plant full of micronutrients (vitamin K! Vitamin C!) that protect one from various diseases; the plant is often stated to have anti-inflammatory and anti-cancerous properties. Awesome. Unless you have hypothyroidism since cabbage is one of the foods that interfere with the thyroid function.

Dairy! Gets a lot of bad rep from the paleo community and others. While recently thought as very important for bone health and what not, there is a lot of talk that we have not evolved to tolerate it quite well and it is thus an unhealthy substance to consume. Our genes are still adapted to the pre-agricultural diet (before ~10,000 yrs ago), as many paleo proponents will argue. Yet there is evidence to challenge the assumption that humans are essentially unchanged since the Paleolithic era. E.g. “recent” evolution of lactase persistence and variation in the number of genes that code for amylase production tied to starch consumption. In other words, mutations have occured that allow many folks to digest and thrive on dairy and grains just fine.

– Phytates. Plants have a lot of great ingredients that generally affect us positively (e.g. vitamins protecting from disease), but it depends.. For example, phytates in grains and nuts are usually viewed as bad for us because they can bind to certain dietary minerals leading to deficiencies (iron, zinc, etc.).. In West Africa, many Hausa plants contain substantial amounts of these phytates (especially in cereals and legumes) but these botanical chelators have a potential malaria-suppressive effect (awesome!!). However, this anti-malarial effect may be antagonized by antioxidants in other foods (e.g. such free radical traps as Vitamins C, E, beta carotene, selenium). Antioxidants is something many of us try to increase in the diet..yet if you are living in malaria-prone regions of the African continent, you might want to concentrate on the opposite dietary strategy- phytate-rich and antioxidant-poor foods.

989898So is there an objectively healthy diet? Generally- all eating is healthy since it is required for survival.. undereating and overeating is not good.. lacking a variety nutrients is not good.. and that’s mostly it. Of course, different things work for people- someone might not tolerate dairy, others might feel miserable on a vegan diet; some thrive on salads others can’t digest raw plants well. If only we could all grasp the wonderful concept of moderation and apply it in our lives without struggle. In fact, it is because self-control is so hard to maintain that we want simplified solutions- a diet plan, a list of “bad” foods to simply avoid, etc.

Happy Holidays– don’t overeat on most days, yet don’t let yourself stress so much about what you’re eating that you are unable to enjoy life! 😉 *grabs a big fat piece of dark chocolate and kicks back*.

What makes us FULL? (macronutrient perspective)

Sometime in the semester, I heard people speak about satiety (satiation is the process of feeling full & terminating food ingestion during the course of eating) in relation to protein and fat (protein apparently is more satiating, even though fat has more calories).  Feeling of fullness is important- it is one of the problems I faced as a raw vegan, which made sticking to the lifestyle very hard long-term (I was raw vegan for ~2 years).

So instead of preparing for class tomorrow, I am reading up on satiety! Some main points:

Most importantly- it’s not all about the calories, since not all calories are treated equally by the body.  The hierarchy of fullness is the following: Protein > Carbs > Fats. So, protein satiates more than carbohydrates, and fat is least satiating (which came as a surprise to me considering it has most calories per weight). High-fat foods have a weak effect on satiation.

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Within the macronutrient categories, we find differences too: not all carbs exert the same effect on satiety (fiber has been consistently shown to have a higher satiety value vs. simple sugars), and neither does fat (the medium-chain triglycerites [e.g. the wonderful coconut oil] seem to be more satiating).

Of course, people don’t eat only to get full. The number 1 reason given for eating a certain food is taste. More specifically- palatability (subjective pleasantness of food). Low-energy-dense foods tend to be less palatable, but more satiating :/

According to the article*, ideally our diet would consist of low-energy-dense foods with high palatability (unfortunately such foods are not very common). This “diet” is one low in fat, has adequate protein and fiber, and includes lots of fruits, vegetables (so food with high water content).

Of course, focusing on whole foods vs. processed makes lots & lots of sense- a whole food product takes time to chew and digests longer (satiety signals are maintained for longer).

Apart from specific studies, common sense must prevail: staying away from “fat” is not necessary (not as much as staying away from processed fat, vegetable oils, etc…), and adding great fats (e.g. avocado!) to meals is both healthy and filling (studies show that while fat on its own is least satiating, it’s power to fill us up increases when it is added to carbs).

Feeling full is important! Constantly feeling deprived could potentially lead to overeatingand more stress.

P.S. I shall probably post more on the subject of satiety later, considering I have a whole class coming up on this topic 😀

*Gerstein, D. E., Woodward-Lopez, G., Evans, A. E., Kelsey, K., & Drewnowski, A. (2004). Clarifying concepts about macronutrients’ effects on satiation and satiety. Journal of the American Dietetic Association, 104(7), 1151–3. doi:10.1016/j.jada.2004.04.027