It appears part of the reason almost 70 percent of Americans are overweight or one in two Americans has pre-diabetes or Type 2 diabetes may not be gluttony, lack of willpower or absence of personal responsibility but plain old, garden variety biological addiction.

Many previous studies have shown how this region of brain, the pleasure center, lights up in response to images or eating sugary, processed or junk food. But many of these studies used very different foods as a comparison. If you compare cheesecake to boiled veg­eta­bles, there are many rea­sons the plea­sure cen­ter can light up. It tastes bet­ter or it looks bet­ter. This is inter­est­ing data, but it’s not hard proof of addiction.

This new study took on the hard job of prov­ing the biol­ogy of sugar addic­tion. The researchers did a randomized, blinded, crossover study using the most rig­or­ous research design to ward off any criticism (which will inevitably come from the $1 tril­lion food industry).

They took 12 overweight or obese men between the ages of 18 and 35 and gave each a low sugar or low glycemic index (37 percent) milkshake, and then, four hours later, they measured the activity of the brain region (nucleus accum­bens) that con­trols addic­tion. They also measured blood sugar and hunger.

Then, days later, they had them back for another milkshake. But this time they switched the milkshakes. They were designed to taste exactly the same and be exactly the same in every way except in how much and how quickly it spiked blood sugar. The sec­ond milk­shake was designed to be high in sugar with a high glycemic index (84 percent). The shakes had exactly the same amount of calories, protein, fat and carbohydrate. Think of it as a trick milkshake. The participants didn’t know which milk­shake they were getting, and their mouth couldn’t tell the difference, but their brains could.

Each participant received a brain scan and blood tests for glucose and insulin after each ver­sion of the milk­shake. They were their own control group. Without excep­tion, they all had the same response. The high sugar or glycemic index milk­shake caused a spike in blood sugar and insulin and an increase in reported hunger and cravings four hours after the shake. Remember—exactly the same calories, sweetness, texture and macronutrient content.

This finding was not surprising and has been shown many times before. But the breakthrough finding was this: When the high glycemic shake was con­sumed, the nucleus accumbens lit up like a Christmas tree. This pat­tern occurred in every sin­gle par­tic­i­pant and was statistically significant. This study showed two things. First, the body responds quite differently to different calories, even if the protein, fat and carbs (and taste) are exactly the same. And second, foods that spike blood sugar are biologically addictive.

This game-changing study must force a shift in the conversation about obesity in America. There are 600,000 processed foods in the marketplace, 80 percent of which have added hidden sugar. The average American consumes 22 teaspoons of sugar a day, mostly hidden, and the average teenage boy has 34 teaspoons a day (more than two 20 ounce sodas).

One serving of Prego tomato sauce has more sugar than a serving of Oreo cook­ies. Sweetened yogurts can have more sugar than a can of soda.

Sugar is the core ingredient used by the food industry to make bad ingredients (processed flour and chemicals) taste good. Our consumption has increased from 10 pounds per person in 1800 to 140 pounds per person per year today.

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