00:14:05.160cognitive or behavioral differences were as likely to be found between sham diets as they
00:14:11.720were between experimental diets. And the few differences associated with the ingestion of
00:14:17.400sucrose were more consistent with a slight calming effect than with hyperactivity. Interesting. So like
00:14:24.520A, people were reporting bigger differences around the fake made up diets. They're like
00:14:29.860cosmetic changes. Yeah. And B, if there was any effect, it wasn't really statistically
00:14:35.940significant, but it appeared that it was actually like chilling kids out a tiny bit.
00:14:40.460So give kids sugar if you want them to calm down. That's the maintenance phase endorsement.
00:14:45.400Yeah, exactly. Around the same time, there is an editorial in the New England Journal of Medicine
00:14:51.620from Dr. Marcel Kinsborn, who's a pediatric neurologist and says that actually like,
00:14:58.480this is kind of a chicken or the egg situation, right? Like does sugar consumption make you less
00:15:04.880inhibited or does disinhibition lead to an increase in sugar consumption? Right, right, right. And
00:15:11.240ultimately, Dr. Kinsborn includes this pretty like mic dropy quote. He says, there is no evidence
00:15:18.340that sugar alone can turn a child with normal attention into a hyperactive child. The same
00:15:23.560applies to aspartame, which has also been suspected of causing behavior disorders in some children.
00:15:27.880Sugar clearly does not induce psychopathology, where there was none before, but it may on occasion aggravate an existing behavior disorder.
00:15:37.020Sugar-free diets can be burdensome and socially inhibiting, and they should not be endorsed purely on the basis of anecdotal evidence.
00:15:43.960So basically, there might be some conditions that maybe your kid has that makes them hyperactive.
00:15:51.400But at the population level, we just can't say that there's any link between sugar and hyperactive behavior or like hyperactive disorders or other like mental conditions.
00:16:01.640Right. At this point, we're talking about 10 years of research reviews, RCTs, all of this kind of stuff that keep looking for this link and keep not finding it.
00:16:12.080Right. I remember reading a super fascinating study years ago on the effects of alcohol.
00:16:17.480We often think that things like, you know, bar fights are kind of the way that people act when they're drunk in Western societies.
00:16:25.100We think of those as like the biological effects of alcohol.
00:16:28.600But what this study pointed out was that alcohol effects are actually very cultural.
00:16:33.640And there's some societies where it leads to a ton of violence and there's some societies where it doesn't, like where it's like, I love you, man, kind of drinking.
00:29:40.080the last thing i'll say on this point is that the glycemic index also isn't recommended for
00:29:46.100individual use by the american diabetes association for people with diabetes they
00:29:50.960rate the current data as poor quality there is some evidence that the glycemic index may be
00:29:56.640helpful in prevention but it is not recommended in treatment right so again the folks who
00:30:03.580ostensibly need it the most are not recommended to use this as their tool for deciding what
00:30:10.020to eat right so basically it's like any other framework i guess where it's like maybe useful
00:30:15.380in certain circumstances i mean maybe people use it and like it and that's fine but as a sort of
00:30:21.320population level recommendation it just isn't very meaningful yeah and it's hard to figure out it's
00:30:26.300not very intuitive you have to have these tables with all these pages and pages of results and0.97
00:30:31.880then of course all this stuff breaks down too as soon as you go to like a fucking restaurant0.96
00:30:35.240These conversations are mostly happening among people who are not diabetic, don't have PCOS, and don't necessarily have insulin resistance.0.97
00:30:42.220So they're mostly people, as a result, who have a very imprecise understanding of blood glucose and how it all works, right?
00:31:53.420I genuinely would not know. I have not done cocaine.
00:31:56.260dude i thought due to the dare program that i would constantly get offered cocaine and like
00:32:03.140i am not cool enough to have ever been offered cocaine in my whole life and like i absolutely
00:32:07.820would have done cocaine if someone had offered it to me so listen i had a co-worker at one point
00:32:12.000who described me as having a two-drink personality that's good right he was like it's like you've
00:32:19.180already had a couple of drinks that's kind of your vibe yeah i might say there is already a
00:32:25.300whisper of cocaine in your default setting, right? Yeah, a little bit. So turning up the volume on
00:32:30.560that is really something. Imagine my little voice and personality. So I sent you a little clip of
00:32:37.000how this is getting sort of billed in mainstream media outlets. This is a clip from Good Morning
00:32:42.040America from about two years ago. The fucking title is studies show added sugar can be just0.98
00:32:48.860as addictive as street drugs. Street drugs. Again, I'm livid that I've never been offered1.00
00:32:53.820cocaine on the street. All right, everybody, time to check your sweet tooth. Are you addicted to
00:33:00.540sugar? Some studies in the field of nutritional science and medicine show that diets high in
00:33:06.000added sugar can be as addictive as some street drugs like cocaine. So cutting added sugar from
00:33:12.180your diet if you're consuming too much can have some powerful and significant and positive effects
00:33:17.540on your overall health. There's actually been a very significant body of medical research,
00:33:24.240nutritional science research, that shows using a test called a functional MRIs, that when people
00:33:30.460ingest foods that are high in added sugar, that the same part of their brain that gets stimulated
00:33:36.340when they get exposed to cocaine also gets triggered and stimulated with foods that are
00:33:42.040high in added sugars. In general, the more added sugar in a food, the more that brain reward center
00:33:49.520will be triggered, making you want more and more of it. Okay, so I should stop doing cocaine and
00:33:56.600I should stop eating sugar. And if I stop eating sugar, that'll have the same benefits as cocaine.
00:34:00.680We should say that the research that exists around sugar and the dangers of sugar are all about
00:34:05.740added sugars. So we're not actually talking about the sugar that exists in a nectarine or
00:34:12.240the sugar that exists in oats or whatever, right? Like we're not talking about sort of naturally
00:34:18.680existing sugars. We're talking about in the preparation of a food, someone adds cane sugar,
00:34:24.740honey, fructose, whatever, and sweetens a food. That's what we're talking about with most of this
00:34:31.060research, but we're not very good at making those distinctions individually. And it has allowed
00:34:37.400quite a few diets and quite a few spurious claims about any form of sugar. Right. This is a tough
00:34:44.640one because again, like feelings run high here. I know and love a number of people who consider
00:34:50.860themselves like deeply consider themselves to be addicted to sugar. I also know and love people who
00:34:57.600are in recovery from addiction to drugs and alcohol who are profoundly frustrated with this
00:35:04.120discourse around sugar addiction. My goal here isn't to get in between anyone and their understanding
00:35:10.460of their own body, but to take a look at what the research says about this thing that's popping up
00:35:15.000more and more as kind of a buzzword and a really snappy kind of claim, right? I think one of the
00:35:20.000problems is that the term addicted has a bunch of like different kind of individual and social
00:35:24.620meanings and also has this element of physiological addiction like you go through like actual
00:35:30.680withdrawals but then there's also psychological addiction like i i remember years ago i interviewed
00:35:36.300a psychologist about sex addiction and what he said is that like on some level you can get addicted
00:35:40.560to anything like you can get addicted to skiing to the point where it disrupts your work life and
00:35:44.700your social life and that's a real thing and you don't want to take that away from people if they
00:35:49.460say that they're addicted to something, but it's also distinct from physiological symptoms of
00:35:55.480addiction. Yeah, absolutely. I mean, like there are lots of ways to talk about addiction and
00:36:00.040dependency and sugar addiction as a concept in the research is debated. There was one 2016 review
00:36:08.580in the European Journal of Nutrition that reviewed the available data. And here is what they said.
00:36:18.280i'm sending you a brick it says we find little evidence to support sugar addiction in humans
00:36:22.700and findings from the animal literature suggest that addiction-like behaviors such as binging
00:36:27.240occur only in the context of intermittent access to sugar not the neurochemical effects of sugar
00:36:33.340okay so we don't find it in humans and when we find it in animals it's like if you restrict
00:36:39.300their sugar intake for a while then they kind of like binge on it when they finally get access to
00:36:44.480it. Right. So that's a 2016 review. Here's a 2018 review from the British Journal of Sports
00:36:51.780Medicine. It says, consuming sugar produces effects similar to that of cocaine, altering
00:36:56.840mood, possibly through its ability to induce reward and pleasure, leading to the seeking out
00:37:02.340of sugar. It's not a great sentence. It's not a great sentence. That's true. When this study came
00:37:07.940out, one of the authors went even further and told The Guardian, quote, in animals, it is actually
00:37:13.880more addictive than even cocaine. So sugar is pretty much probably the most consumed addictive
00:37:20.520substance around the world. And it is wreaking havoc on our health. That 2018 meta-analysis that
00:37:28.720says sugar is as addictive as cocaine led to really significant backlash with nutrition
00:37:35.540researchers oh yeah but the soundbite sugar is as addictive as cocaine made it much further than
00:37:43.980the backlash which is like more nuanced more reasoned you have to talk to more people versus
00:37:49.260like somebody makes a graphic on instagram and is like sugar's as addictive as cocaine and it
00:37:53.160gets shared a hundred thousand times and then there you are right here is what appears to have
00:37:58.840happened okay it appears that the authors of the 2018 study may have straight up misunderstood the
00:38:06.400animal studies oh those studies restricted rats to having sugar for two hours every day okay but
00:38:15.380when you take away the restriction the quote-unquote addictive behaviors also went away
00:38:21.160oh okay the rats did the same thing they had the same quote-unquote addictive behaviors for saccharine
00:38:28.200for the artificial sweetener oh so this appears to be about sweetness not about sugar per se
00:38:34.840oh like the taste sensation in this study rats were offered sugar water saccharine water or
00:38:41.800cocaine water dude seriously yeah i've never been offered that either
00:38:46.140i'm livid these rats are offered these different things and then they're given levers right to get
00:38:53.200more of the thing and the evidence here is the sugar rats wanted the most of the sugar
00:38:58.920but also so did the saccharin rats and the cocaine rats didn't necessarily want a huge
00:39:05.000amount of cocaine water the cocaine rats were too busy explaining the podcast they're about
00:39:09.140to launch there's a piece in the guardian about this called is sugar really as addictive as
00:39:15.800cocaine scientists row over effect on body and brain row was invented to help headline
00:39:22.660writers fit their headlines. In this piece, they talked to a Cambridge psychiatrist who was like,
00:39:28.180yeah, I mean, rats are going to eat food and not cocaine.
00:39:35.660Fair point, Cambridge psychologist. Yeah, man. Yeah. I should say that this one is debated in
00:39:42.860part because the data just isn't there yet. Multiple reviews on this topic describe the
00:39:48.160data as nascent or in its infancy. Many of the studies that we're talking about are mouse and
00:39:54.860rat studies. They're animal studies. There are some human studies, but not as many as there are
00:40:00.280rat studies. It's also debated because dopamine and brain response alone may not actually
00:40:07.800constitute the same kind of dependency as drugs or alcohol. The core argument about sugar addiction
00:40:15.700is that sugar consumption leads to dopamine release, lighting up the same part of our brain
00:40:23.500as drug use. As you noted, that is kind of just a pleasure center of the brain. Sugar has a little
00:40:31.400bit more of an impact, right? Like it, it creates more of that response, but lots of foods create
00:40:37.140that response in your brain, right? It appears that drugs like cocaine, like heroin, like opiates
00:40:43.300sort of writ large, actually hijack the controls of that reward center and make it stop working
00:40:49.780or work less effectively over time. We don't really have data that shows that with sugar.
00:40:55.480I get a dopamine response every time I get a poke on Facebook.
00:40:58.440Who's poking? Are we getting in the time machine going back to 2007?
00:41:02.960I wanted to see what reaction that would get from you. Nothing. You gave me nothing.
00:41:07.460I gave you nothing. I have nothing to say about pokes.
00:41:10.320this episode has about one million sources but there are two books that were particularly helpful
00:41:19.360and both of them are forthcoming later this year oh how did you read them how did you get these
00:41:24.540i'm fancy because of our show people sometimes email us and say hey do you want to read this
00:41:30.160book before it comes out and i say yes will you open those emails also one of them is a book that
00:41:37.320i read and ended up blurbing because i liked it so much what you read
00:41:41.580the trail like a chump wow um so those two books that are coming out later this year
00:41:50.540um are fat talk parenting in the age of diet culture by virginia soulsmith oh virginia yeah
00:41:57.840we love virginia yeah and the second is by someone i don't know it is called sugar rush
00:42:05.200science politics and the demonization of fatness it's by karen throsby and it's out in august i'm
00:42:13.560livid that you didn't rely on any youtube videos for this this is a quote from fat talk parenting
00:42:20.560in the age of diet culture by virginia soulsmith virginia out later this month by the way pre-order
00:42:26.060it team she says dopamine is also known as the feel-good hormone it surges in our brains whenever
00:42:32.060we experience pleasure, and defenders of the sugar addiction model cite this as evidence
00:42:36.160because the sugar-dopamine response can look like the response seen in the brains of people
00:42:40.400using narcotics. But we also get dopamine responses from purely benign activities like
00:42:45.180seeing a puppy, hugging a loved one, or feeding our babies. People who feel addicted to sugar
00:42:49.900interact with it quite differently than people who struggle with alcohol or drug dependency.
00:42:54.160So-called food addicts don't endanger their children or lose their life savings to obtain
00:42:58.180their highs. So even the chair of the UK organization Action on Sugar acknowledges that
00:43:06.460sugar is fundamentally different than other substances that we consider addictive. Right.
00:43:12.600In 2014, Graham McGregor, who's the chair of Action on Sugar, told The Times, quote,
00:43:17.900I agree that sugar is not like tobacco. It's not as addictive, but it's a major source of hidden
00:43:23.720calories. And if you get it down, it will help with obesity. It's an overstatement. Sometimes
00:43:30.220to get your point across, you need to make it stronger. Yeah, this is the thing we've confronted
00:43:34.580a lot before where it's like a lot of this stuff that sort of seems like scientific messaging
00:43:39.340is actually like policy messaging. Yeah, it's social. Yeah, it's designed to be rhetorical or
00:43:44.800to like reach a goal. Part of what happens when you invoke an addiction model is that you also
00:43:50.740invoke all the trappings of that model, right? And the main way, certainly in the US that we
00:43:57.420engage with addiction is abstinence, right? And it is not very feasible for people to fully abstain
00:44:05.460from all forms of sugar. And it's also not great for your body to not have any kind of glucose
00:44:11.300entering your system. Yeah. In the absence of a clear sort of scientific consensus here,
00:44:16.120our cultural attitudes about sugar and addiction both have sort of moved in hard to like fill the
00:44:22.700gap, right? Sugar has long been discussed as a possible sort of dietary cause of people getting
00:44:30.080fat. It's been long discussed as a dietary cause of people getting diabetes, all kinds of stuff
00:44:35.600that we heavily stigmatize. Addiction is also something that we heavily stigmatize, right?
00:44:43.000Right. So when someone proposed that sugar was addictive, it reinforced two very deeply held sets of biased beliefs that fat people can't control themselves and that addicts are sort of like wretched and to be pitied and don't have self-control.
00:45:01.580and they sort of did it to themselves sort of the vibe right with addiction yeah and what it's
00:45:06.520rhetorically trying to do is bring some of the suspicion and fear and alarmism that we bring to
00:45:14.160conversations about drugs to sugar now but again we don't actually have research that bears that
00:45:20.960out we might at some point who knows but as it stands we don't have research that very clearly
00:45:28.820illustrates any kind of like again scientific consensus that sugar is an addictive substance
00:45:34.700yeah i don't understand why people are doing this i think they're doing it for like marketing or
00:45:38.860like public relations purposes because like it doesn't seem like it's supported by the biological
00:45:45.180evidence at all it seems like they're doing this maybe as a way of like reducing stigma like oh
00:45:51.600they can't help it they're addicted or something but like i i don't think this is gonna have that
00:45:55.340effect. I think this is probably coming from a similar place as the redefinition of quote-unquote
00:46:01.920obesity as a disease, right? Yeah. Which is sort of the desire to garner more attention to an issue
00:46:08.060that some researchers feel like isn't getting the attention that it deserves. It's messaging that's
00:46:12.940designed to kind of grab you by the lapels and shake you, right? It has the side benefit, you
00:46:20.280know, quote unquote benefit, right, of reinforcing how we already feel about food, making more fear
00:46:27.720about food in a time when we're sort of moving in a slightly more anti diet direction or have been
00:46:34.260right. This is a way that you can reclaim your deep fear and discomfort around food that feels
00:46:40.680beyond reproach, right. And it's a way that you can think and talk about fat people without
00:46:46.120explicitly saying fat people you can talk about sugar addicts and sugar addiction and the scourge
00:46:50.920of sugar addiction i think there is this idea that that might be less destructive right that
00:46:56.280like an addiction frame is less stigmatizing i would say have some conversations with some addicts
00:47:01.180i just don't think that these like very superficial relabeling of the terminology around
00:47:08.240widely stigmatized groups like really does anything i think you can call like fatness a
00:47:14.580disease or not call it a disease, but like fat people are very stigmatized in our society.
00:47:18.620Yeah. So the only thing that's going to happen is they're just going to attach the stigma to
00:47:21.660the new term. I am of a mind that if there are new terms coming about to describe a particular
00:47:26.600minoritized community, that that should be the decision of that community, not the decision of
00:47:32.340doctors who are like, I've decided this is what's best for you. And any sort of rhetorical move that
00:47:39.200you use to amplify your message has some consequences, some of which you will foresee
00:47:44.360and some of which you will not. I mean, this is clearly a rhetorical move to get people to think
00:47:49.720differently about sugar. But what it has done is created a really fundamental misperception
00:47:55.540of the sort of like chemical functions of sugar in your body, right? This sort of use of an
00:48:03.060addiction parallel really lends a sense of urgency, right? That this is like a matter of
00:48:10.240life and death that we can't fuck around. Right. And that's not actually what's happening with0.99
00:48:15.420sugar. Right. Right. There is no such thing as one day you have too much sugar and then you die0.86
00:48:20.100if you're not like diabetic or something else. Right. Yeah. There's no opioid overdose analogy
00:48:24.960to sugar. Right. What we're talking about is for, say, the onset of diabetes years and years and
00:48:32.140years of creeping up blood sugar that can be caused by lots of things and as we learned earlier
00:48:38.300different things for different people and different sugars for different people right
00:48:43.780it's caused by cucumbers that's what i learned in the last hour that's what you
00:48:46.700that's where we left it right oh that's why i'm fat i keep drinking tea