Most of us can remember the early 2000s low fat diet trend that stemmed from the 70s—where anything labeled as low fat was a green light to consume. Fat had been demonized by the American Medical Association (AMA) and other important medical groups because of its supposed negative impact on heart health, and these groups also argued that it caused obesity. To break it down to sound bites: If you eat fat, you will get fat. Fat = bad, carbs = good.
What started this idea? Back in the 1960s a physiologist named Ancel Keys published a theory that dietary fat raises cholesterol levels and gives you heart disease. This began a decades-long era in which all dietary fats were thought to be bad for your health. In the late 1970s, Dietary Goals for the United States was published, advising Americans to significantly curb their fat intake, and in 1984, the National Institutes of Health (NIH) officially recommended that all Americans over the age of 2 eat less fat. Turns out, they were all very wrong. But at the time, because the public had been sternly warned to avoid fats in fear that they would die from a heart attack or end up obese, most Americans were ditching the fats and, instead, eating more and more carbs. People were (falsely) led to believe that you could indulge guiltlessly on high sugar foods, because they were labeled as “fat-free” and were carb-heavy. Back then, it was fat that was bad for you, so companies were doing you a favor by taking it out of the products.
The problem was that if you take the fat out, the food usually tastes terrible. So, the food companies added sugar to make it taste good again. Sugar is a carbohydrate, so it was safe, and heck, better for you than the dreaded fat!
All the while in the background, it was becoming apparent that sugar might not be all that good for us. Many people for years had been talking about how they craved sugar, had a sweet tooth, and how giving up the white stuff is so hard. Giving up desserts and sweets was usually the tactic to try to lose weight, and usually the downfall for most dieters because it was hard to stick to.
I started to look more carefully at some of the processed food products that were on the market—many contained so much added sugar, and in amounts that we would never ever see in nature. As a neuroscientist I knew that the parts of the brain that evolved to regulate our appetite were used to concentrations of sugar that were more like what you would find in, for example, an apple. But now, our brains are being blasted multiple times each day with the effects of 10 times that amount of sugar from cookies, cakes and protein bars. Not to mention all the sugar-laden foods that people are eating because they think they are healthy, like some yogurts, salad dressings and fruit smoothies.
A lot of things have changed since our ancestor hunters and gatherers roamed the earth. Now, we modern-day hunters and gatherers still forage for food, but in a very different environment. For one, we don’t have to work very hard to get food. We can click a button online and get groceries delivered. No need to wander around all day looking for some edible grasses; Uber Eats will deliver! Second, the menu has changed. We no longer have a finite and very limited number of options for nourishment, which would have included hunted duck, deer, fish and foraged vegetation like wild berries, nuts and greens, but rather, we have thousands of choices—just not all of them are healthy ones. And lastly, the food itself has changed. Most of it isn’t even actual food anymore.
What do I mean, it isn’t food? Well, it depends on how you define what a food is. The dictionary definition of a food is “any nutritious substance that people or animals eat or drink or that plants absorb in order to maintain life and growth.” I added the emphasis, as these are the key words: nutritious substance and maintaining life and growth. That should be what all foods do, by definition, right? Our modern food supply is predominantly highly processed “food.” It is combinations of ingredients that include additives, colorants, and chemicals and flavorings that have been specially designed to ensure that the “food” will last on a shelf for an extended period without spoiling, and also taste really good so that people will want to buy more of it. And one of the best ways to make something taste good is to—you guessed it—add sugar. Sugar is the new norm—and we have the data to back all of this up. Americans are consuming more sugar than ever. Back in the 1750s, the average American consumed about 1 teaspoon of sugar per day. Compare that to today—we consume, per person, an average of 22 teaspoons per day!
The standard American diet reminds me of what happens with consumption of drugs like heroin and cocaine. Part of the reason drugs like these are so addictive is because they over-activate the brain reward centers. They hijack the reward system and set our pleasure into overdrive. Drugs make you feel good (at first, at least), and our brain adapts accordingly to make us crave that feeling again and again, which makes us do almost anything to get it. I started to ponder: what if these processed foods that were so commonplace in our society, with loads of added sugar, were hijacking our brains in the same ways that drugs of abuse do?
I have learned so much over my career about the damaging effects of sugar, and the damage goes even further than I initially thought. Sugar has not only been shown to have destructive effects on metabolic health, but new research shows that it can negatively impact learning, memory and impulse control, just to name a few things. Many of the medical conditions that plague adults, such as diabetes, cardiovascular disease and fatty liver disease, are now being tied back to our diet—with sugar as the main culprit.
Sugar is a silent killer. You aren’t going to drop dead from eating one cookie, but many years of having a poor diet that is rich in added sugar will not only reduce your life span, but it will also make it much more likely to be fraught with illness, disease and unhappiness.
The worst part about all of it is that, even though we know all of this, we continue to live in a world that is sugar centric. Sugar is everywhere. It is pushed on our kids from a young age. It’s at the checkout line in almost every store. It is hidden in food products under different names. It is unavoidable. And if you happen to be one of the many people whose brain has been hijacked by it, you are stuck in the sugar vortex and probably feel like you can’t get out.
For some people, sugar addiction is a result of necessity. For many people these processed foods are the only reliable food option available. More Americans are living in what are known as food deserts, or poorer neighborhoods with limited access to fresh and healthy food. Low income and low access to food are the two features used to assess whether a region should be considered as a food desert.
It is also known that there’s a correlation between poverty and obesity, and this is seen not only in the U.S., but globally. One study found that countries with poverty rates greater than 35 percent have obesity rates 145 percent higher than wealthy countries. Many families, due to financial reasons or lack of access, or both, are reliant on the corner convenience store as their primary place for purchasing food.
I have been inspired by the stories that people have shared with me of both anguish and success, and I want to help. I want to help you break free from your sugar addiction. I want you to have first-degree access to the science behind all of this, so you can understand what sugar does to your brain, and how it can grab hold of your ability to control your intake. But more importantly, I want to empower you with the psychological and behavioral skills and tools that you need to break from the powerful hold of sugar and change your brain in a way that will change your life, forever. My new book, SugarLess goes deep into the neuroscience and nutritional science to help you understand and break free of your sugar addiction—with no diets, no gimmicks and no fads. This is evidence-based, everyday tools you can use to make logical sense of what you should and shouldn’t eat.
Nicole M Avena. SugarLess: A 7-Step Plan to Uncover Hidden Sugars, Curb Your Cravings, and Conquer Your Addiction. 2023.
Keys, A., Taylor, H. L., Blackburn, H., Brozek, J., Anderson, J. T., and Simonson, E. (1963). Coronary Heart Disease among Minnesota Business and Professional Men Followed Fifteen Years. Circulation, 28(3), 381–395. https://doi.org/10.1161/01.cir.28.3.381.
Ricciuto, L., Fulgoni, V. L., 3rd, Gaine, P. C., Scott, M. O., and DiFrancesco, L. (2021). Sources of Added Sugars Intake Among the U.S. Population: Analysis by Selected Sociodemographic Factors Using the National Health and Nutrition Examination Survey 2011–18. Frontiers in Nutrition, 8, 687643. https://doi.org/10.3389/fnut.2021.687643.
Dr. Nicole Avena is an associate professor of neuroscience at Mount Sinai School of Medicine in New York, NY, and a visiting professor of health psychology at Princeton University in New Jersey. She is a research neuroscientist and expert in the fields of nutrition, diet and addiction, with a special focus on nutrition during early life and pregnancy, and women’s health. She has done groundbreaking work developing models to characterize food addition and the dangers of excess sugar intake. Her research achievements have been honored by awards from several groups including the New York Academy of Sciences, the American Psychological Association, and the National Institute on Drug Abuse. In addition to more than 100 peer-reviewed scholarly publications, Dr. Avena has written several popular books, including Why Diets Fail: Because You’re Addicted to Sugar, What to Eat When You’re Pregnant, What to Feed Your Baby and Toddler and What to Eat When You Want to Get Pregnant. He latest book, Sugarless, will be released in December 2023. She frequently appears as a science expert in the media, including regular appearances on Good Day NY, The Doctors, and the former Dr. Oz Show as well as many news programs. Her work has been featured in Time Magazine, Bloomberg Business Week, The New York Times, and many other periodicals. Dr. Avena is a member of the Penguin Random House Speakers Bureau. She has the No. 2 most watched TED-ED Health talk, How Sugar Affects Your Brain, with more than 16 million views and counting.