As I began to pen this article, a thought of the gummy worms lurking in my kitchenâs snack drawer crossed my mind. I couldnât resist the urge, so I stood up and helped myself to a handful. Itâs worth noting that I had just wrapped up lunch and gummy worms are not my favorite.
Yet, I found myself munching on them.
This seemingly trivial moment is not uncommon in my lifeâand perhaps in yours too: indulging in a treat devoid of any real nutritional value. My snack consisted mainly of sugar, combined with ingredients that offered little more than synthetic flavors, carnauba wax, and a rainbow of artificial colors. As I read the ever-growing ingredient list with increasing disdain, I popped another gummy worm into my mouth.
Nonetheless, after completing this story, Iâll afford myself a bit of grace. Thereâs increasing awareness that these ultra-processed foods are meticulously crafted to keep us craving more. Foods laden with sugars, crunchiness, saltiness, and creaminess can linger in our minds, inciting us to reach for another handful.
Recent research suggests these items possess addictive qualities, akin to the cravings fostered by alcohol, nicotine, and opioids. Certain specially engineered foods, typically a blend of fats, sugars, and salts, can evoke such overwhelming urges to consume that they might warrant classification as addictive substances.
Highly engineered foods can infiltrate the brainâs reward pathways, triggering potent âeat moreâ messages. Studies indicate that ultra-processed foods can result in cravings, diminished control, withdrawal symptoms, and toleranceâcharacteristics often associated with substance use disorders.
Multiple questions linger about their impact on our bodies, which demographics are most vulnerable to overeating such foods, and effective strategies to regain control. Yet, understanding how these pervasively available food products influence our brains and overall health is increasingly critical. In fact, more than half of the average caloric intake in the United States is now attributed to ultra-processed foods.
Ultimately, the intent behind research on food and addiction is to empower individuals with insights into how their dietary choices affect their well-being, asserts neuroscientist Alex DiFeliceantonio from the Fralin Biomedical Research Institute at Virginia Tech Carilion in Roanoke. However, she also highlights a concerning juxtaposition: âA food companyâs objective is to encourage you to consume more.â
In a summer publication in Nature Medicine, a collaboration of addiction and nutrition experts, including Nora Volkow, director of the National Institute on Drug Abuse, present evidence suggesting that many food products âshare greater traits with addictive substances than with naturally occurring foods.â They assert that it is vital for policymakers and researchers to heed these warnings and take appropriate action.
Are ultraprocessed foods truly food?
As someone who consumes foodâessentially everyoneâI thought I had a solid grasp on what constitutes food. However, Ashley Gearhardt, a psychologist at the University of Michigan in Ann Arbor, suggests that my cheese puffs might not qualify.
55
percent
Average caloric intake in the United States from ultraprocessed foods from 2021 to 2023
âThese items arenât really food. Theyâre hedonically optimized creations made through processing for corporate gain,â she explains. âWe canât overlook ultraprocessed foods solely because they contain calories.â
Nicole Avena, a neuroscientist at Icahn School of Medicine at Mount Sinai in New York, questions the terminology itself: âIâm uncertain whether we should continue to classify these as food,â she remarks. âIâve taken to calling them food-like products.â
If these âfood-like productsâ arenât truly food, then what exactly are they?
The category of âultraprocessed foodâ is as nebulous as a pastel Peep. For years, food scientists have experimented with various ingredients, preservatives, and bulking agents to enhance foodâs shelf life, visual appeal, and flavor.
Using the NOVA classification framework, foods are divided into four categories: unprocessed or minimally processed (such as an apple or chicken), processed culinary ingredients (like sugar or butter), processed foods (including cheeses or canned vegetables), and ultraprocessed foods (like hot dogs or potato chips).
62
percent
Average calorie consumption by children aged 1 to 18 from ultraprocessed foods
âUltraprocessed caloric conglomerates typically incorporate little to no whole food components and are packed with additives,â remarks Tera Fazzino, a psychologist at the University of Kansas in Lawrence.
These products are assembled from concentrated sugars and fats stripped of their natural form, often enhanced with additives to bolster flavor and texture. Theyâre then wrapped in eye-catching packaging branded with familiar logos.
âJust as a cigarette bears little resemblance to a tobacco leaf, an Oreo cookie holds minimal similarities to the corn and soybeans it derives from,â iterate Volkow, Gearhardt, and their colleagues in their Nature Medicine article.
These commodities have been prevalent for decades, permeating our lives. In 2003, ultraprocessed foods represented approximately 51 percent of home calorie intake; by 2018, this figure had nudged up to just over 54 percent.
53
percent
Average calories consumed by adults aged 19 years and older from ultraprocessed foods
In 2019, Fazzino and her team published a paper presenting a related yet distinct term: hyperpalatable. This term accurately captures foods that are irresistibly delicious and practically irresistible. Fazzino highlights that conventional foodsâapples, carrots, salmonâare also palatable and provide rewarding signals, but hyperpalatable options elevate that to a whole new level.
Consider childrenâs breakfast cereals. A recent investigation has unveiled a decline in fiber and protein content in U.S. cereals from 2010 to 2023, while fat, salt, and sugar levels have risen. These findings, reported on May 21 in JAMA Network Open, serve as one example of broader industry shifts away from nourishing ingredients in favor of tastier alternativesâremoving elements like fiber that promote satiety, while emphasizing those that enhance taste, provokes overconsumption.
âThereâs a significant overlap in the U.S. food market between hyperpalatable and ultraprocessed foods,â Fazzino notes. In other regions, including some countries outside the U.S., this overlap appears diminished, potentially due to less intense processing practices.
âThey process it, package it, and thatâs different from intensively enhancing its flavor,â Fazzino explains.
Tracing the history of food and addiction research
Years ago, discussions surrounding food seldom intersected with those of addiction. However, around 2007, food policy specialist Kelly Brownell from Yale University and addiction researcher Mark Gold from the University of Florida began exploring these intriguing associations. Their dialogues culminated in a pivotal meeting at Yale that summer, merging the realms of addiction and nutrition for the first time.
Half of the invited participants hailed from nutrition and obesity fields, while the other half were drawn from addiction studies, according to Brownell. Initial skepticism lingered about whether the concept held value, questioning if addiction could adequately frame discussions surrounding food.
âThe addiction experts were quicker to embrace the notion that food could trigger addictive behaviors than their nutrition counterparts,â Brownell reflects. âThe latter were less familiar with considering addictionâs concepts.â Over time, acceptance of the idea that ultraprocessed foods could provoke addictive reactions gained traction.
As a graduate student in the early 2000s, Avena observed parallels between sugar consumption and addiction, consistent with guidelines from the Diagnostic and Statistical Manual of Mental Disorders (DSM), which outlines criteria for substance use disorders.
âIt was somewhat tumultuous initially, as this was a novel idea,â she recalls. Yet the research progressed, consistently revealing correlations with other addictive substances. A crucial facet involves the brainâs reward centers, particularly the striatum, which plays a vital role in motivation and pleasure. The striatum responds when beneficial stimuli are detected, such as an influx of energy-dense sweet substances.
Neuroscientists have amassed evidence from animal and human studies demonstrating how ultraprocessed foods can alter brain dynamics akin to those of other addictive materials. Investigations have unveiled neurochemical changes, structural modifications, and variations in activity within critical brain regions.
âNeurochemical changes are observable in the brainâs responses to food that resemble those linked to alcohol or drugs,â Avena affirms. Researchers have identified alterations in reward system activity mediated by neurotransmitters like dopamine, serotonin, and endorphins. Many of these shifts likely heighten awareness towards food.
DiFeliceantonio and her colleagues discovered that individuals consuming a high-fat, high-sugar yogurt dessert daily for two months exhibited heightened neural responses to food cues in brain regions connected to reward. This dessert effectively restructured these volunteersâ reward pathways, amplifying their motivation towards indulgent foods. Interestingly, these individuals also excelled in cognitive tasks, something that surprised DiFeliceantonio.
Understanding the compulsion to indulge
Nonetheless, substance use disorders encompass complexities that exceed mere experimental measurements by neuroscientists. They encompass combinations of behaviors, emotions, triggers, and backgroundsâtraits such as compelling cravings, repeated but failed attempts to quit, and continued use despite acknowledged harm.
Gearhardt functions as an addiction clinician who encounters patients vocalizing their struggles with these foods. âThey insist, âIâm addicted to this stuff! I know itâs destroying my healthâI have diabetes and Iâm at risk of going blind, yet I canât stop,ââ she shares. Others often dismiss their struggles, asserting they should simply try harder, count calories, or focus on macros.
Listening to such testimonies reinforced her belief that lurking dangers are inherent in these foods. Evaluating the current DSM substance use disorder criteria confirms that some individuals exhibit behaviors and symptoms indicative of problematic eating patterns surrounding ultraprocessed foods, according to researchers. These findings draw from nearly 300 studies spanning 36 nations.
Applying the Yale Food Addiction Scale, approximately 14 percent of adults and 12 percent of children exhibit criteria consistent with food addiction, figures eerily akin to estimates surrounding alcohol use disorder. This survey probes eating behaviors, inquiring if individuals ever overindulged to the point of distress or harbored overpowering food cravings.
In preliminary findings, DiFeliceantonio and her team found that 18- to 21-year-olds on a diet rich in ultraprocessed foods consumed more than their counterparts adhering to a minimally processed dietâeven absent feelings of hunger. This trend didnât hold for slightly older adults aged 22 to 25. Identifying which populations may be more influenced by varying food types remains an ongoing pursuit.
Food classification framework
The NOVA classification system categorizes foods based on their processing levels rather than nutritional content, ranging from one for unprocessed/minimally processed foods to four for ultraprocessed foods.
Unprocessed/minimally processed
Meat
Eggs
Fresh, frozen, or dried fruits and vegetables
Grains and legumes
Processed ingredients
Salt
Sugar
Butter
Starches
Oils
Processed
Canned foods
Salted nuts
Cured meats
Fruit in syrup
Cheeses and fresh bread
Ultraprocessed
Packaged snacks
Ice cream
Instant meals
Energy bars
Should ultraprocessed foods be subject to regulation?
As awareness surges regarding how ultraprocessed foods have been ingeniously crafted to keep us munching, attempts to reduce consumption can seem Sisyphean, particularly for those without access to fresh, wholesome food. Even when unprocessed options are available, they can be pricy and demanding in terms of preparation time and tools.Â
Nonetheless, progress is being made. Federal agencies are scrutinizing these products, particularly with a focus on childrenâs nutrition. Several states are considering prohibiting ultraprocessed foods within schools. A lawsuit was also filed in Pennsylvania against food companies accused of knowingly marketing addictive products despite understanding the associated risks. Although the suit was dismissed, similar actions could follow.
As tobacco products underwent more stringent regulations, many companies shifted toward food products, Fazzino observes. Research tracking food sales from 1988 to 2001 indicated that tobacco-affiliated companies were more likely to offer hyperpalatable foods compared to other firms, as reported in 2023 in Addiction. âTobacco companies in the U.S. systematically played a role in embedding these hyperpalatable items into our food landscape,â Fazzino states.
Currently, various movements aim to enhance school meal offerings, promote clearer labeling, and educate the public about identifying âhealthwashedâ unhealthy products.
âIâm not convinced we should still be referring to them as food. Iâve taken to calling them food-like products.â
Nicole Avena
Neuroscientist
Efforts to regulate ultraprocessed food items continue to gain traction, irrespective of whether experts classify them as addictive. When asked why the perspective of addiction is significant, DiFeliceantonio replied: âIt circles back to considering how we navigate choices in a challenging environment.â If a product is engineered to be irresistible, âthen your choices may not truly belong to youâtheyâre influenced by that substance,â she added. âIf these foods are indeed addictive, making rational decisions regarding them becomes incredibly difficult.â
âWeâve accumulated enough information to recognize that, on a population level, ultraprocessed foods are detrimental to our health, contributing to shorter life spans and heightened disease burden. Yet we continue to tell people to simply avoid them,â she argues. Considering the addiction perspective underscores the inadequacy of simplistic strategies.
Furthermore, much of what we define as normal or abnormal behavior stems from societal constructs, Avena emphasizes. âIf alcohol consumption is socially accepted, itâs fine. But, of course, itâs not appropriate for children to drink alcohol,â she points out. The same logic applies to processed foods: âTheir constant presence at parties or in kidsâ lunches has normalized them.â
A shift in public perception regarding the risks associated with ultraprocessed foods may spur change, Avena contends. âAwareness of the potential dangers prompts individuals to reconsider their choices.â
In response to rising public scrutiny, some food manufacturers are beginning to revamp their products to align with healthier standards, she observes. âIf enough consumers demand less processed alternatives for items like donuts or Lunchables, we can see companies adapt, as is already happening,â she suggests. Numerous smaller brands are emerging, focusing on creating highly nutritious options designed for people on GLP-1 medication without the excessive sweetness or processing.
However, the most impactful pathways to transformation may stem from stronger regulations that enforce healthier food norms, impose taxes on unhealthy options, and necessitate transparent labeling. In Chile, stringent regulations surrounding packaged foods laden with sugar, saturated fats, salt, or caloriesâspecifically, many ultraprocessed itemsâhave demonstrated positive results, according to Brownell. This nation has restricted advertising, implemented taxes on select products, and required clear warning labels. These initiatives seem to have influenced consumer buying trends, with reductions in sugar, salt, and overall caloric intake from products with warnings.
âWhen we shift the narrative to focus on individual responsibility, rather than addressing the root of the issue, which is these addictive food products, we fail to offer genuine solutions,â Fazzino remarks. âAs a society, we deserve protection from elements that may cause us harm.â