Experts warn of coming war over ‘food addiction’ and public health

SAN FRANCISCO — The difference between “food addiction” and “food and addiction” will gain public policy significance as the prepared food industry gears up to fight a growing body of data indicating processed foods contribute to negative public health outcomes. The remarks were made by the outgoing director of the Rudd Center for Food Policy & Obesity at Yale University.

“If there is an addictive impact of food on the brain, what does that say about the accountability of the food industry for intentional manipulation of ingredients, what kinds of advertising should be permitted, and what products should be permitted for sale in schools?” said Kelly Brownell, PhD, who is leaving Yale to become the dean at the Sanford School of Public Policy at Duke University this summer.

Kelly Brownell

Brownell’s presentation was part of a symposium on hedonic eating, addiction and obesity presented here at the 2013 American Psychiatric Association Annual Meeting.

He said these kinds of questions should not focus on food addiction, which is experienced by a small percentage of the population and goes to the morality or pathology of the individual, but instead on “food and addiction because [that] destigmatizes the person and puts the focus on the substance instead.”

Brownell also remarked that growing literature indicating that processed foods negatively affect the brain equals a “game-changing concept … because if it’s true that food can hijack the brain, you can imagine how parents are going to feel about this when their children are exposed to these ‘substances.’ It could come down to helping us protect children’s food environments, much like we try to do with tobacco and alcohol.”

He also said these data “could activate a whole new field of potential players involved in this area,” such as attorneys general and litigants interested in the discourse of how food affects the brain and public health.

‘Public health crisis’

In the presentation directly preceding Brownell’s, Robert H. Lustig, MD, a pediatric endocrinologist at the University of California, San Francisco, demonstrated how food additives such as refined sugar and high fructose corn syrup increase appetitive hormones and “reward” feedback in the brain, while reducing the hypothalamic malyonyl-CoA levels, which are responsible for controlling food intake. This amounts to a craving for more food, while the body’s ability to detect satiety is simultaneously suppressed.

Robert H. Lustig

Lustig said of the roughly 600,000 items in the American food supply chain, 80% of them have added refined sugar, HFCS, or both; and, that there are 56 different names for the various types of sugar. “So, how do you reduce consumption if you don’t even know you’re eating it,” he said.

Lustig, who has written for academic and general audiences about the dangers of sugar, calling for the regulation of sugar consumption by children aged younger than 18 years, said his data indicated that the disruption by these additives of the brain’s signaling system contributes to rising levels of obesity and patterns of processed food consumption that “fits all DSM-IV criteria for addiction.” He added, “Medicare in 2024 will be broke if we don’t approach this as a public health crisis.”

Legal implications

Advertising by processed and fast food manufacturers “willingly manipulate and exploit the idea of cravings and addiction,” according to Brownell, noting that food in its natural state has never been known to create a public health hazard, so when food is deliberately processed into products, the brain is unaware and health issues emerge. “There’s a bad environment driving this,” he said. “These foods are toxic because they are hijacking the brain.”

Brownell outlined the criteria involved in determining whether legal action might be appropriate: “A product must be safe with its intended use. When injury occurs, this duty is breached. The liability is enhanced if the product is addictive. Did the manufacturers knowingly modify products? Were the consumers warned?”

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To determine the answers to these questions, Brownell said an extensive discovery phase would be necessary, including the release of manufacturers’ internal documents. “But some of the things that are leaking out suggest the industry knows a great deal about the impact of food on the brain,” he added.

Food industry ‘will fight back’

Although Brownell conceded that attorneys general are not taking action yet, he anticipates the growing evidence base linking processed food and addiction will mean that industry “soon will see it as a threat and will fight back. They will fund our fellow scientists who will do studies that show food is not addictive … and seek to undo everything that has been done in the scientific community so far. They will start classifying everything that has been done so far as ‘junk science’ by biased scientists,” he said.

The processed food industry also will lobby government for laws that shield them from litigation, according to Brownell. “This is already happening,” he said. “There are a number of states that have what are known as ‘Cheeseburger Bills,’ where the fast food industry in particular is exempted from law suits claiming health damages from their products.”

Brownell told the audience not to be surprised if at next year’s APA meeting scientists paid by the food industry will be on hand to convince attendees that there is no link between processed food and addiction.

Regardless, Brownell said, “Emerging science shows that fast food companies do keep us addicted.”

For more information:

Symposium 106. Presented at: American Psychiatric Association 166th Annual Meeting; May 18-22, 2013; San Francisco.

Disclosure: The researchers report no relevant financial disclosures.