Can sugar cause addiction among humans? A review to find biologically plausible reasons.

Introduction: The concept of food addiction has gained popularity in recent years. This concept purports that certain foods (such as food with high palatability, high caloric value, and foods that are highly processed) have addictive potential. Sugar addiction represents a specific case of food addiction whereby the addictive substance is a specific nutrient, namely sugar, which is usually sucrose. Objectives: To discover evidence for whether sugar has addiction potential in humans or not. Material and Methods: A literature survey was carried out in electronic data bases like PubMed, PubMed Central and Google scholar using the keyword "Sugar addiction". Of 91 search results (from 1/1/2000 till 30/9/2016), after application of the inclusion and exclusion criteria, 10 articles were included in this review. Results: In the literature, addiction has been characterised by four stages: bingeing, withdrawal, craving and sensitisation; sugar has shown all these stages in various studies. Animal studies have shown that sugar and other sweet substances result in the production of neurochemical substances such as dopamine, endogenous opioids, and acetylcholine in the brains of animals. In humans, evidence showed that sugar and other sweet substances can induce craving that is comparable to those induced by cocaine and have also showed that a liking for carbohydrate sugar beverages increases over time [p 0.05]. Conclusions: Strong evidence has been found that foods that have more sugar content and high palatability can induce a reward and craving comparable to addictive drugs. However, more research in humans is clearly needed to confirm this conclusion as most of the studies are on animals. Dental Public Health Significance: Sugar addiction has been found to be related to an increased incidence of obesity, cardiovascular diseases, and diabetes as well as dental caries around the world, which makes it a major public health problem. Keywords: Sugar addiction, plausibility, bingeing, withdrawal, craving