Artwork for podcast Baggage Check: Mental Health Talk and Advice
Your Brain on Sugar: Dr. Nicole Avena on a Not-So-Sweet Problem
Episode 715th November 2022 • Baggage Check: Mental Health Talk and Advice • Dr. Andrea Bonior
00:00:00 00:48:49

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We all know that sugar isn't exactly the tip-top of nutrition. But when it comes to mental health, how does it truly affect our mood and behavior? Is sugar addiction real? And if we want to make genuine changes in our intake of it, where do we start-- and why is it so hard? Today we're joined by Dr. Nicole Avena, a neuroscientist at Princeton University whose groundbreaking research on sugar's effects on the brain raises serious questions about what we're up against, psychologically, in a world where sugar is everywhere.

For more information on Dr. Nicole Avena, her research, and her upcoming book, check out her website and follow her on Twitter.

Follow Baggage Check on Instagram @baggagecheckpodcast and send us your questions!

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Cover art by Danielle Merity

Music by Jordan Cooper

Transcripts

he War of the Oaken Bucket in:

Dr. Nicole Avena: Oh, thanks so much. I'm happy to be here.

Dr. Andrea Bonior: So, sugar. I hear from so many people that this is something that they try to make changes on, that they really don't like in terms of their diet. I just want to start with this overall problem. I mean, I'm guessing there's no doubt that, especially in the United States, we eat differently than we did 50 years ago. Can you tell us a little bit about the history of this problem and how it's gotten so bad?

Dr. Nicole Avena: Yeah, you know, it's something that really does have a lot of history to it. And I'm glad that you brought that up as sort of the first talking point here, because I think a lot of what we're realizing about why we're facing so many issues with obesity, with lifestylerelated diseases, it's really going back to our nutrition and how we eat and how that has changed over the past 50, 100 years. What we've seen over the years is that we've had an influx of highly processed foods. And so if you think back to grandparents, or even great grandparents, if you're lucky enough to remember them, they eat very differently. It wasn't really like it is now, where everything is in a package and you're really just focused on convenience and the fact that, let's just see what we can eat that is going to just take a few minutes to cook as opposed to maybe a few hours. And so as a result of that, what we've seen is that many of these foods have an excess amount of sugar in them. And, uh, over time, that's really been correlated with many of the problems that we're seeing nowadays. Not only with obesity, but with other types of conditions. cardiovascular disease, increased risk for certain cancers. Really, just a lot of the health conditions that we're seeing these days can be tied back to what we're eating. And a lot of that has to do with more added sugar that we're seeing in the diet.

Dr. Andrea Bonior: And so it stands to reason, I guess it's pretty obvious that with processed food, they're just adding a lot of sugar that wouldn't otherwise be there. I hear, okay, sugars in all these different foods that you wouldn't necessarily expect, is that right? That we're making our own tomato sauce 60 years ago, we wouldn't be shoving as much sugar in it?

Dr. Nicole Avena: Yeah, I mean, there's a couple of reasons why you see so much more added sugar in the processed food. So the first one is actually to mask some of the taste that comes from having to add many of the ingredients that are added to make it a processed food. So in order to have something to be able to live on a shelf for two or three years, you sometimes have to add some chemicals to it and those aren't going to necessarily taste all that great. And so sometimes sugar, uh, is added, multiple sugars are added, different types of sugars are added to mask those tastes so that they're not offcutting. And then in addition to that, people like the taste of sugar, right? And so we know this. And so it doesn't really hurt to add extra sugar. If you want someone to like your product and to want to eat more of it, why not add more sugar? And so the food companies are aware of this. And so that's where we are in terms of why we're seeing sugar added to so many different things. So it's really not so much the fact that there's a reason to add all this sugar. The reason is really consumer demand. I mean, and I see this, even with my kids, something that I think is really too sweet, almost like aversive, they don't necessarily see as being all that sweet. And there's a couple of reasons many kids live in and depending on their age, their threshold for what's sweet is different than what adults are. But also I think it's a fact of how they've grown up. I mean, my kids have grown up with this sugar storm, if anything. Right? Yeah, I guess my kids may be a little different because of what their mom does for a living, but I'd say their peers amongst them. These kids are basically surrounded by sugar. Twenty four, seven. And so when they taste something that's sweet, it actually doesn't really taste as sweet in comparison to the things that they're used to eating all the time.

Dr. Andrea Bonior: Yeah.

Dr. Nicole Avena: And so I think that's why we're seeing more products with more sugar, um, because it's really almost like a tolerance is developing and more sugar needs to be added because people just aren't feeling the vibe from the sugar that's already in the products.

Dr. Andrea Bonior: Yes. You know, it's so interesting, that idea that some of the preservatives or chemical taste needs to be covered up. I think that's not really discussed that much. We talk about processed foods, but we don't talk about the fact that maybe one of the reasons for these additives in terms of the sweeteners is so that you won't taste some of the chemical aspects of it. Is that true, incidentally, for salt, too? Uh, because I hear as well that a lot of extra salt is added to processed food. Is that generally another type of flavoring that has to be added, maybe to counteract some of those chemical tastes?

Dr. Nicole Avena: It's similar. Yeah. I think salt helps more on the preservative side of things than sugar helps as a preservative, too. But I think in terms of masking the taste, the sweetness is really going to serve as more of a cover than the salt taste would. But for sure, that's part of the reason why we see on many products, excess amounts of salt, more than you would want to consume in one serving. And so, um, when you think about these different products and what goes into making them, it's really very much a science experiment. In my class that I teach at Princeton, I show up a bunch of different products that are manmade types of items, like Pop Tarts, for example. And they look like they're basically just a pastry that you put in the toaster. But in reality, they're pretty difficult to make in terms of creating them from scratch. And when you think about all the different ingredients that go into them, if you ever look at the ingredients list, I mean, there's so many different ingredients and additives, and they're put in there for a reason. It's so that the Pop Tart is going to melt in your mouth a certain way. It's so that when you open up the wrapper, it's going to smell a certain way. I mean, there's a whole process, there's a sensory process to eating. It's not just about something tasting good, but it's about the smell. It's about all of our senses essentially get engaged when we eat something. And so that is an important piece of it, and that build up is important, and that's what leads people to want to consume something. So that is why I think we see a lot of sugar added in places where you wouldn't necessarily expect it. And it serves a dual purpose, right? In addition to covering up some of these off putting tastes, it also helps to make it even taste a little bit better than it would.

Dr. Andrea Bonior: This is so fascinating to me because I'm picturing a bunch of scientists-- not chefs, not cooks. I'm picturing a bunch of scientists standing around and saying, how can we optimize this in terms of people liking it enough that they'll buy more? And at some point, it's about the bottom line of sales and money. Is that a fair assessment? That this really is corporation driven at some point? Hey, if we use this chemical in these chips and people eat more per serving than they normally would, am I being cynical? Is that kind of what it boils down to?

, I have a book coming out in:

Dr. Andrea Bonior: Mhm.

Dr. Nicole Avena: And so companies were able to use high fructose corn syrup to sweeten products for a lot less cost wise, and a lot less in terms of bulk of having to buy product than they were with cane sugar or sugar beets. And so that was really a turning point, because then we started to see sweeteners being added to basically everything, right? Because now it became cheap, became easier to, um, import. And that's where I think we started to see things fall off the rails a little bit. And so it does have a lot to do with money. It does have a lot to do with keeping customers, I think, interested in the products and having them stay relevant, having them stay delicious and tasty. And the reality is that many people have been so accustomed to eating these highly sweetened food products that one of the things people often ask me is, well, why don't we just tell the food companies to put less sugar in it and see what happens? I'll tell you what's going to happen. No one's going to buy it. People don't want it because they're so accustomed to having it be really sweet. And so it's going to be aversive. It's a psychological principle that goes back to general psychology. It's called negative contrast. And so if I give you something that tastes really good, like if I give you $50, and then I said, you know what, actually I'm only going to give you $20, well, that $20 isn't going to seem that great anymore after I told you I was just going to give you $50. Same with sugar. If you're used to having more, when I tell you you're going to get less, it's not going to be, you know, as accepted.

Dr. Andrea Bonior: Yeah, completely. And I imagine that's especially true if some of the ways that our brain has been used to responding to sugar and eating sugar are in place. You mentioned the word tolerance before, almost, that, uh, people get used to this in a way. So I'd really love to hear more about how sugar is processed in the brain, mood wise, cognitively, chemically, and how we've gotten into this cycle, because I do work with so many people who say, I can feel it. I can feel that if I try to go lower sugar for a few days, or if I go without my morning sugary coffee, of course, caffeine is a whole separate thing. But even just sugary drinks that they might be used to, I can feel my craving get almost insurmountable. So why don't you walk us through a little bit about when sugar hits our tongue. What starts happening?

s is going back into the year:

Dr. Andrea Bonior: Yeah. Because in the past, it feels like sugar-- maybe mothers were telling their kids, hey, don't eat a lot of sugar. But it wasn't the number one demon. Right. I mean, we have these kind of cultural phases that we go through where for a while, it's fat. Oh, everything should be fat free. And I remember as a teenager this huge influx of fat free products, and I have to laugh because fat free cookies, fat free this, fat free things that maybe wouldn't have even naturally had fat. But I have to laugh because in retrospect, I think a lot of those things had even extra sugar put in. Is that right?

Dr. Nicole Avena: Yeah. Do you remember Snack Wells?

Dr. Andrea Bonior: Yes, that's what came to mind.

Dr. Nicole Avena: Yes. I remember sitting there with my mom when I was a teenager, and she'd be like, oh, look, I got these great cookies. We can eat as many as we want because they're fat free. And we're like, Great, this is wonderful. But what the package didn't tell us was that they were loaded with sugar.

Dr. Andrea Bonior: Yes. And so, ironically, in a way, they were part of this vicious cycle, and yet people thought that this is something that's not as unhelpful for my body as if it had fat in it. And I think of all the sort of foods where maybe there are good fats or naturally occurring fats that aren't going to harm you as much as some of the trans fats or whatever. And instead of just having those, we were turning to these processed packages of things that promised fat free and the implication that these were health foods. And marketing seems like the marketing and just capturing that cultural moment is so important, and that's part of this is whatever the zeitgeist of the culture at the time is willing to think, oh, this is how I'm supposed to eat. Because it can be so trendy if marketers capture that they can take it and run with it, even though they might be driving our health downward in the process.

Dr. Nicole Avena: Absolutely. And I hate to say it, and I might get some hate mail because of this, but that's okay. I think a little bit of that might be happening with the keto revolution right now, because a lot of people are focused on this ketogenic diet, which I think, when done correctly, can be wonderful and can be a healthy way to eat, but when not done correctly, it can be damaging to your health. Many people think, oh, this is great, I just stay away from sugar, but I can eat hamburgers and salami all day long. Mhm, that's not good. That's not good. So it's really, I think, making sure that we don't fall victim to these, like you said, marketing traps to some degree and really understand the science behind these different dietary recommendations and what it actually means for your health. Because I think, like you said, you hit it on the head. The whole fat free revolution, it was damaging in the sense that all people heard was it has to just be fat free. Fat free equals m healthy. And that's not true. That is absolutely not true because it also cut out all the healthy fats. I mean, if you are fatfree, you didn't consume omega three fatty acids and there's fat in fish and we need that for our brain health.

Dr. Andrea Bonior: Yes.

Dr. Nicole Avena: So I think the problem with getting things down to these bitesized messaging points for the media, for marketing, it doesn't work when it comes to our health because health advice goes well beyond just a ten second sound bite. And I think that's where we fall into trouble lately because people's attention spans are getting less and less and less, and the message has to really be whittled down. And you know, my concern is that that's just not conducive to understanding enough about the science behind nutrition and diet. And it's important to understand that because this is what's helping us thrive and keeping us healthy.

Dr. Andrea Bonior: Yes, and you're so right. I think so much of what we hear, especially now, I just saw some new data about how folks that are under 30 social media is just as trusted, are almost just as trusted for them, for news, as national outlets that have been around for 70 years or whatever. And I can understand they still might be vetting sources on social media. But I think the thing about social media, no matter where the source originally is from, is that it is so condensed, it is so bitesized. And I think when it comes to health decisions, certainly we can see this with the pandemic. When we condense things too much, things get lost in the translation and it's oversimplified. And it's so concerning because I feel like from an emotional and psychological standpoint, our habits, they solidify so early. You know, I talk with my students all the time when we talk about disordered eating, for instance, and maybe the other end of the spectrum from obesity, this idea that sometimes it's those early messages as a kid that happened around the dinner table that stick with us for decades. If we can't actually make changes, the inertia of food, if you think of how often we have to eat and how much we're conditioned with every meal to start building certain habits it really makes me sad that some of these marketing messages or misinformation campaigns can kind of take hold of folks from early on in life. And the next thing you know, this is how they've been eating for 20 years. And it's associated with the ways that they feel. It's associated with their mood, it's associated with where they find comfort, with how they socialize, with what they consider pleasure. And I work with so many people who want to make changes, but it feels so tough. And I never want to demonize anyone who really is struggling with this, because so much of it, I think, is just going with the tide of our culture. And food is so emotional in terms of what it means to our family, what it means in terms of how we soothe ourselves and comfort ourselves. So when we think about even trying to start making some changes, I mean, obviously we're going to always consume some sugar. Sugar can be a joy. It can be a wonderful part of life. How do you even begin to start conceptualizing what small changes might look like or what moderation might mean to try to counteract some of these more addictive effects, but also come towards some sort of balance?

Dr. Nicole Avena: Yes, I think the balance is key, and moderation is key. And we hear those words a lot. And the problem I think I have now with that is nobody knows what moderation is and what's moderation in my family might be different than what's moderation in your family. And um, I'm learning this as my children are getting a little bit older and spending time with other families and visiting a friend's houses and things like that. And so I think that that's where it can be difficult because not everyone is on the same page with what moderation means.

Dr. Andrea Bonior: Yes.

to help you get through your:

Dr. Andrea Bonior: Right.

Dr. Nicole Avena: So I think there's so many facets of the conversation, but I think coming to some determination of what moderation is and how do we get there is really the important question that I think is difficult for many people to answer.

Dr. Andrea Bonior: Yeah, I'm struck by how just starting with observation seems to be really important. And we find that with any behavioral habits, start with a baseline of let's really open our eyes and be honest. We don't have to be judgmental. We can be curious, we can be gentle, but let's actually observe what realistically we're taking in sugar wise throughout the day. It's like somebody wanting to stop chewing their nails. Let's look at really how often you're doing it and what settings you're doing it, what's triggering you to do it. And I feel like that's probably the important step one, because some of us might have a longer way to go with this than other people. For some people, it might be really an adjustment that in some ways is a pleasant surprise. Like, okay, it turns out I'm not consuming most of my sugar at dinner. If I make a few tweaks with how I do soda or the really sugary coffee during the workday, maybe that's where the bulk of my sugar is coming. So starting with observation, sounds like maybe that's step one. Let me actually look, let me sort of compare some of my habits, and I imagine that's really important from a mood perspective too. If we can start observing our moods, why do I go for that second chocolate. Granola bar in the middle of the afternoon? Is it because I'm tired and my mood is already slumping? Is that a good place to start for people to try to look at their habits that way?

Dr. Nicole Avena: Yes, absolutely. One of the things I recommend is that people really just take a snapshot of their day and just look at, you know, when you take a food diary and you really, like, sit down and write down everything you eat throughout the day and think about how were you feeling when you ate that and what kind of led to that decision. It can really be very telling because it's often the case that people will make food decisions based off of their emotions. And so if you're experiencing a stressor, or if you have, let's just say, a hectic period of the day, people sometimes opt for the less healthy, more sugary option. And that's because we know that sugar can make us feel better. It's a comfort food. It can basically be a way to self medicate to help us feel temporarily a little bit better. And so it's not uncommon that we see that happening. And I think that that's really important because when people start to reflect and realize, oh, wow, I get home at the end of the work day, and it's chaos, and I'm trying to cook dinner and there's all these things happening, that's when I'm maybe eating things that I don't necessarily now view as being healthy, maybe I can make changes. So when you can kind of look at your situation and see where is the sugar being introduced and what kinds of habit changes could you make that would make it easier to avoid? That can be really telling because you can change your situation and that, uh, can make it easier in terms of what you choose to eat. The habit piece of it is really important because a lot of people find that their sugar consumption is just very habitual, that it's tied to some other behavior. It's tied to, for example, the end of the day when everybody's asleep and in bed and you're winding down, that's when you're going to maybe watch television. And then all of a sudden, now you're eating cookies or something tied to that. And so it's really very much often part of a habit. Same with the afternoon coffee. It's just your kind of way to get through the rest of the day.

Dr. Andrea Bonior: Right.

Dr. Nicole Avena: And it's different for everybody. But when you can identify those parts of your day, that can be one step toward making changes so that you can m get some of the sugar out of your diet.

Dr. Andrea Bonior: Yeah, and I imagine that's really empowering, too, once you actually have your own personal data, so to speak, to be able to say, hey, this is something I can tweak this is something I can change, and maybe I can find a tool in that moment that actually gives me what I'm looking for, that doesn't make me feel worse later, like after eating more sugar, that maybe if I find that when I'm lonely or tired or bored or just sluggish, there's another way to get my energy up. I'm going to take a quick walk outside during my lunch hour, or whatever it might be. I think it can be really empowering for people, and I see that all the time. When people finally sort of clue into, here's the little tweak I can make, they feel like they have a path forward rather than just this general, oh, I wish that I didn't eat so much quote unquote junk, or however they want to put it.

Dr. Nicole Avena: Exactly. And I think one of the things that can be empowering to people is when they realize you don't have to completely revamp your life and change everything about it in order to make these types of changes. It can be something as small as literally going to the coffee place and just saying, oh, I'm going to have a cappuccino with just regular milk and no sugar, no whipped cream. I mean, and you can still go there, have that same experience, and walk out and enjoy the coffee. And to be honest, a lot of it is the lead up to that experience that we're conditioned to that piece of it. And so these small changes that people make, they're not going to be life changing in the sense where you're going to feel like, oh, I've had to completely revamp my routine. But they can be life changing in the sense that you might find that this could be the thing that's going to launch you forward with making these changes that are going to be beneficial to your health, right?

Dr. Andrea Bonior: And you can really tap into the other aspects of that experience that are still rewarding. I like the feel of a hot mug of something in my hands, even though it doesn't have as much sugar. Or I, uh, like the feel of taking a little tiny afternoon break, but instead of going to the vending machine, I'm just walking outside and getting some fresh air. Or I think so many times. We think, like you said, that we have to make these wholesale, huge changes, when in reality, if there's a little ritual that we have built around sugar, we can probably get away with. Removing the sugar part and still maintaining some part of the ritual, whether it's a little break from work, whether it's a little proverbial breath of fresh air or time with friends or something like that, that we're associating solely to have to need that sugary treat or sugary snack. Now, I do want to address the flip side of the spectrum because I think certainly in my field, and especially teaching at a high achieving place like Georgetown University, I see a lot of the other end of the spectrum too. And even with things like keto or people who are getting overly rigid with certain diets and maybe doing it in a way that doesn't make sense. But I think probably not at all the answer to then have the draconian approach, maybe with our kids or the way that we even think about sugar. I mean, that's another part of moderation too, right? Being able to think, hey, we're not going to say sugar is this absolute devil that we avoid at all costs. How do we conceptualize that for ourselves? Or how do we start talking to kids? I mean, you have kids, obviously. Is there a way that you have come up with the message that doesn't demonize it and make disordered eating in the other direction more likely?

Dr. Nicole Avena: Yes, that's a really great point. And I think when it comes to kids and young people especially, I think the message should never be don't eat this, don't eat that. Mhm, it should be why you should limit it. And I think there's a couple of reasons for this. One, because you can tell somebody not to do something, but kids are eventually going to become teenagers who are going to then rebel and they're going to do the opposite. And if they don't understand from a fundamental level, like why they shouldn't do something, then it's not going to set in with them. And I think it's more important to teach our kids how to police themselves, how to understand, oh, if it was Susie's birthday at school and I had a cupcake, why I shouldn't come home and then ask if I can have a cupcake after dinner for dessert. So just helping kids to really understand the time and the place for Sweets and also helping them to understand where suites are located. That's another thing that's difficult, especially for young people and, uh, even for adults, is that sugar is hidden in so many different foods, you don't even necessarily realize how much you've had. Unless you're really savvy about looking at the labels on our food products. And when people say, oh, I don't eat any sugar, I completely cut it out. I say, that's great, if that works for you and you're still eating a balanced diet, then that's wonderful. But I don't think that should be the goal for everybody. I think the goal for everybody should be to move toward eating less of it and maintaining control. I think that's the key marker is are you in control of how much sugar you're eating? And I think that's where we get into this question of is somebody potentially addicted to sugar where they have that loss of control piece, they can't say no, they can't eat just one cookie, they can't have just a few bites of ice cream, they feel compelled to overeat and then that's what we're talking about. An addiction forming versus, you know, someone who might just not necessarily be addicted to it, but feel like they need to get a better handle on being able to moderate it. And I think a lot of it comes down to just helping people to be better educated about how do you moderate it, where is it? I mean, you can't moderate something that's hiding in places, right? I mean, if alcohol is hidden in all of our different foods, how can we be expected to moderate? When you drink alcohol, you know what has alcohol in it, right? I mean, you know, it's an alcoholic beverage. Same with we don't give our kids alcoholic beverages because we know the things that have alcohol in them. M. But with sugar we don't know. And you don't know the dose of sugar, right? I mean, it's not always so clear when it comes to these sugar rich foods, which ones contain sugar and how much, so that's where it can be a challenge to moderate. But I really think that should be the goal of moderation and minimizing, not necessarily completely abstaining, because I don't think that that's going to work for everybody.

Dr. Andrea Bonior: Yeah, and I don't think psychologically abstention makes sense either, because sugar is so much a part of how we can sometimes derive joy from these special treats. And I like the idea and you alluded to this, of, um, thinking about the time and the place. And I've certainly seen parenting shift a little bit in certain circles, trying not to demonize certain foods, which I completely agree with, to thinking about certain foods as treats that are sometimes foods rather than, oh yeah, I'm gonna have a candy bar every meal. Hey, candy bars are nice and they can be fun, but we will not feel our best selves if we have them all the time. There is sometimes things, and I know with my own kids, when they were younger, I would try to get them to think about and be observers of their own body. Like do I feel kind of sluggish? Or I would talk about teeth a lot. We can't eat a ton of sugar because then our teeth are going to have a problem. And I tried never, ever to make it about weight or shape or size or anything like that or any kind of moral judgment, but just let's be honest about how we feel. And speaking of kids and sugar, I am curious to be able to ask a neuroscientist is the whole sugar crash or the sugar explosion? You know, I know in parenting circles it's always a cliche like uh oh, they had some birthday cake, now they're literally bouncing off the walls because of that. Is that truly a thing? Is that what we see? Is that spike in impulsivity and hyperactivity with kids and then the crash later on?

Dr. Nicole Avena: I think it is, yeah. This has been a question that's been going on for years and there's been some back and forth in the scientific literature. Um, to be honest, there haven't been a ton of studies that have been done, like carefully controlled studies to assess this. But there's a debate about whether or not sugar actually makes your kids hyperactive. I mean, we've seen in our lab rat studies that sugar makes our Labrad kid hyperactive for sure. And so I think when it comes to children, I mean, if you take a look at the typical seven year old birthday party, I mean, if you introduce a, ah, giant dose of sugar via a cupcake or a piece of birthday cake to the brain of a child that is already primed for excitement and whatever else partying.

Dr. Andrea Bonior: Yeah.

Dr. Nicole Avena: I can't see how anything else but hyperactivity would result.

Dr. Andrea Bonior: Right.

Dr. Nicole Avena: Um, and so I do think that anyone who has seen a kid or has been to a birthday party would probably agree these things can make your kids go a little bonkers and then the crash afterward. But again, I think that this is why I think it's important to just be mindful of that. And, uh, you know, part of it is we kind of have this lawsuit fair attitude toward that, right? I mean, yeah, I do the same thing. I go to birthday parties and all the parents like, oh yeah, now we're going to give them sugar and then they're going to be crazy and then they're going to crash. And I'm thinking, why are we doing this then? If we know this is going to happen, why are we doing this to them? So part of it is just that people don't necessarily take it seriously.

Dr. Andrea Bonior: Right.

Dr. Nicole Avena: Um, and I think that piece is because most little kids who are overeating sugar, the parents and their loved ones are looking at it like, well, what's the long term damage? Right? Yeah. They're going to be a little hyper for a bit, but then they'll be fine. But the problem is that they're learning these tactics about eating and these habits about eating that they're going to take with them into adulthood. And that's the damage. And so it's sort of like smoking cigarettes, where, yes, you could be a teenager and you're smoking cigarettes, and you're not going to get lung cancer as a teenager from smoking cigarettes, but you're going to be addicted to tobacco and you're going to continue smoking cigarettes, and you're most likely going to end up with cardiovascular disease when you get older. And so it's a longterm condition. And I think that's what happens. And with sugar, it's the same thing. It's starting early in life. It's not showing its effects in terms of its negative effects until kids are no longer kids. And so that's where I think it can be tough for us to tie the two together because the damage from sugar doesn't happen until 20 years from now.

Dr. Andrea Bonior: Yeah. And that parenting, passing down to kids in terms of habits is so key in so many ways, I think. Does there seem to be a genetic basis for some people maybe more prone to become dependent on sugar?

Dr. Nicole Avena: Yes, there's been some research studies that have come out over the past few years, especially looking at the Dopamine gene, certain alleles to the dopamine gene, showing that people who have that gene allele are more likely to be addicted to food. And so there does seem to be this genetic component. Now, I think just like with other types of addictions, you know, gambling or alcohol or drug, that doesn't necessarily mean that someone is destined to become addicted. It just means that they're at higher risk. But I think that's important information, because then if people are aware that they have this genetic propensity, that is a way in which they can maybe make some changes to their environment so that they don't fall victim to that genetic propensity. So I think that information can be really helpful for people in terms of making decisions about their lifestyle.

Dr. Andrea Bonior: Right. I feel like sometimes it's a vicious cycle because a parent who maybe is passing along the genetic propensity is also the one that is determining, hey, here's where we keep the candy in our house, and, uh, here's what we're going to have every meal. We're going to have this, and Haiti wants some soda and that kind of thing. So a kid often has a way to go before they can even be able to make those changes because they've grown up with this. But I think, as you said, it really can be empowering when they look at it. And I think that's the process so many of us go through as young adults is saying, hey, what am I dealing with here? How can I carve out my own life and take with me what I want to take from my upbringing, but also be able to make some adjustments where things don't feel like they set me on a path? That's the path I want to be on. You know, as we wrap up, I am curious about artificial sugar and specifically its role in the brain, because I think a lot of people think, okay, well, maybe part of the process of cutting down on sugar is, okay, in my coffee, I'm going to use this particular sweetener. And once again, there are trends. Oh, use this and not that. Oh, this one is good. That one might have caused cancer. All this information swirling. Do you have any guidance on that in terms of artificial sugar or artificial sweetener, I should say, and also what kind of things it does to the brain, because I feel like we hear metabolically what it might do sometimes, but we don't hear as much about what it might do brain wise, neurologically.

Dr. Nicole Avena: Yeah, great question. I think that the artificial sweeteners, they can be difficult to talk about because I think in some ways they can be beneficial. Right. I think if someone is addicted to sugar and over consuming sugar, if artificial sweeteners can be a way to help wean yourself off of sugar. I think that can be a first step. I don't think it should be the only step though. I think the ultimate goal should be to try to reduce the sweetness in our diet. And the reason is when we consume these artificial sweeteners or these alternative sweeteners, it's still activating the brain. So the sweet taste is what drives this addiction like process. It's not necessarily just sugar or just high fructose corn syrup. It's the sweet taste of these items.

Dr. Andrea Bonior: Okay, so literally, like, on your taste buds that picking up of that sweetness is what drives this process.

Dr. Nicole Avena: Yes, absolutely. And so that's why I think it can be beneficial in the short term maybe to use some of these artificial sweeteners, but in the long term, the goal should really be to reduce the sweetness in your diet. And I think that that's important for people to realize because many of these artificial sweeteners, they're marketed as, oh, just use this instead of sugar and your life will be great. And maybe for some people it would, but for people who are really struggling with overeating sugar, the goal should be to reduce the sweetness. Otherwise you're just going to continue that vicious cycle of addiction.

Dr. Andrea Bonior: That's so striking because really, to me, as I'm hearing that, I'm thinking ultimately what we're not talking about today's calories. Right? It's not about the calories. It's not about, okay, so I had sugar calories, and now I have no calories with the sweetener. It's about that addictive process of how our brain responds to the sweetness. And I think a lot of people might have heard the beginning of this conversation and assumed, oh, this is going to be a conversation about obesity. In reality, it's really not. It's a conversation about being able to take some control of the mood cycle of being dependent upon these sweeteners. Is that a fair? I think so.

Dr. Nicole Avena: And I think I'm glad that the conversation is shifting away from calories and obesity because to be honest, those aren't really the problems. It's what happens when people consume too much calories and obesity can lead to these lifestyle conditions and, you know, these health complications that can ensue. I think that we need to get away from just focusing on, like, how many calories somebody ate or what their body weight is, because those aren't necessarily we have to kind of get back to like, well, what's causing someone to eat the most calories? What's causing them to have increased body weight? And in many cases, we're seeing it's coming down to the sugar and to the behaviors surrounding sugar. And when you talk about reducing your intake of sugar, that's really the best way to reduce your overall caloric intake because not only are you going to reduce the calories that you're getting right at that moment, but you're also going to reduce cravings. You're going to reduce the impulsive eating that's going to help you to reduce those binges and things like that. And I think in the long term, that's really the best way is to get control of your behavior around food, if you're interested in lowering calories and trying to lose weight.

Dr. Andrea Bonior: Right, to really be empowered and understand. And I think there's so much judgment about food and diet and weight and all these things. And I just want to emphasize once more to my listeners that this doesn't have to be about judgment, it doesn't have to be about that. It can be about empowerment and understanding, how you can be able to feel like you can manage your moods better, like you can actually have a more well rounded relationship with food, where there's flexibility and variety and where it's not this rigid way in either direction is. And I need to have my sugar because my brain keeps telling me or I need to have zero sugar because I'm counting my calories. And I need to absolutely get rid of everything that really there's so much about food to enjoy and love. And I always feel like food is one of the inanimate loves of my life, right? Like it's something that really when we can be mindful and develop our relationship with it in a really full way of being empowered about what we're putting in our bodies, I think it can be magnificent. So I'm just so grateful that we were able to have this conversation today. And if people want to see more of your work, if they want to keep in touch with you somehow, is there a place that we can so?

Dr. Nicole Avena: Um, if you go to my website, Dr. Nicolevina.com, there's links to our research articles, all different stories about different topics that are coming out of our lab. Also, if you are on social media, you can find me at @drnicoleavena.

Dr. Andrea Bonior: Wonderful. I really appreciate you taking the time. And yes, we go into the holiday season. I think it's important to say that there is hope, there is some potential for moderation here. What's funny is that I didn't mention my listeners were actually recording this on Halloween this, uh, morning. So if there's ever a time when the word moderation maybe has to be kind of flexible, it's probably Halloween night for those with kids and maybe even for those without kids. But thank you again so much for having taken the time today.

Dr. Nicole Avena: Oh, thank you very much.

Dr. Andrea Bonior: Thank you for joining me today. Once again, I'm Dr. Andrea Bonior, and this has been Baggage Check with new episodes every Tuesday and Friday. Submit your voice memos at baggagecheckpodcast.com and if you have that quirky friend who likes podcasts about thought-provoking issues, please let them know where to find us. Our original music is by Jordan Cooper, cover art by Daniel Merity, and my studio security is provided by Buster the Dog. Until next time, take good care.

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