Addiction to Ultra-Processed Foods Could Meet Criteria for SUD
Addiction to ultra-processed foods is estimated to affect 14% of adults and 12% of children, and behaviors around ultra-processed food could meet the diagnosis for substance use disorder (SUD) in some individuals, according to an analysis released this week by an international group of scientists.
Findings from the study, conducted by researchers in the United States, Brazil, and Spain, were published in a special edition of the British Medical Journal.
“There is converging and consistent support for the validity and clinical relevance of food addiction,” Ashley Gearhardt, the study’s corresponding author and a psychology professor at the University of Michigan, said in a news release. “By acknowledging that certain types of processed foods have the properties of addictive substances, we may be able to help improve global health.”
Although addiction to certain foods is not included in the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), research using the Yale Food Addiction Scale (YFAS) has grown over the past 20 years. The YFAS assesses the 11 symptom criteria for SUD in the DSM-5.
For their analysis, researchers reviewed 2 systematic reviews that included 281 studies from 36 countries. The reported ultra-processed food addiction prevalence of 14% in adults was on par with levels of addiction in adults observed for other legal substances (e.g. 14% for alcohol and 18% for tobacco). The 12% rate of implied addiction for children, however, is unprecedented.
The YFAS is used to report on intake of foods with high levels of carbohydrates or added fats—the types of foods most strongly linked to behavioral indicators of addiction. Refined carbs or fats have been found to evoke similar reactions in the brain striatum as those observed with substances such as nicotine or alcohol. Ultra-processed foods—foods that are industrially produced and contain ingredients not found in home kitchens—are the main source of refined carbohydrates and added fats in the modern food supply.
Whereas an apple has a carbohydrate-to-fat ratio of about 1-to-0 and the ratio for salmon is 0-to-1, the carb-to-fat ratio for a chocolate bar is 1-to-1, which appears to increase the addictive potential of the ultra-processed food.
The behaviors associated with ultra-processed food that were observed included less control over intake, intense cravings, withdrawal symptoms, and continued use despite known harmful consequences.
Based on their findings, the scientists who conducted the study recommended additional research examining the following topics:
- How the complex features of ultra-processed foods combine to increase their addictive potential;
- Further definition of the foods that can be considered addictive;
- Differences in ultra-processed food consumption among various populations;
- Value of public health messaging; and
- Clinical guidelines for preventing, treating, and managing ultra-processed food addiction.
“Given how prevalent these foods are—they make up 58% of calories consumed in the United States—there is so much we don’t know,” study co-author Alexandra DiFeliceantonio, assistant professor at the Fralin Biomedical Research Institute and associate director of the institute’s Center for Health Behaviors Research, said.
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