Tag Archives: food addiction

Junk Food Light bulb


When we hear the word addiction, many of us think of severe, negative outcomes: drug addiction, alcoholism, even workaholic tendenciesFood, by contrast, is rarely thought of in this same light. The truth isespecially when it is highly processed, highly sweetened food, it can be as addictive as many drugs 

Not surprisingly, researchers have found that Oreo cookies may be as addictive as cocaine when it comes to rewarding the brain’s pleasure circuits.[1] These neural networks handle the emotions of reward and pleasureThink of them as a set of lights: They can be turned on, but their default position is off. When you consume alcohol, take drugs, or consume a lot of sugar, for example, the response inside the brain is very similar. The “lights” get switched on. 

Drugs and alcohol have self-limiting mechanismstake too many drugs or drink too much alcoholand you will experience many adverse side effects. You will also suffer social problems, whether marital, familialor professionalThus, social norms prevent us from over-consuming these substances. Likewise, if we ignore the initial side-effects and continue over-consuming, our bodies have several unpleasant ways to tell us to stop.

Food has very few such self-limiting mechanisms. You can eat all day, every day, and there is nothing besides a weak satiety signal stopping you from doing so. In fact, since eating is required for survival, there are reward mechanisms for periodically over-consumingFurthermore, there is no social penaltyovereating is practically encouraged at family gatherings and parties, for exampleYet it is a very dangerous game to play, once you realize that food is addictive.

Foods might not be acutely toxic, but over time, constant over-eating can cause significant damage. There is an obvious reason why 40 percent of the country is now obese. Few people have stated the obvious: In simple terms, Americans are eating too much, and many people are addicted to food.

A new study presents a greater understanding of the mechanism behind food addiction, concluding for the first time that there are a specific set of brain cells that, once activated, make us more impulsive around food.[2]

Using a rat model, the researchers at the University of Georgia focused on a subset of brain cells that produce a type of transmitter called melanin concentrating hormone (MCH). While previous research has shown that elevating MCH levels in the brain can increase food intake, this study is the first to show that MCH also plays a role in impulsive behavior.

To test a rat’s impulsivity, researchers trained the animals to press a lever to receive what was described as a “delicious, high-fat, high-sugar” pellet. However, the rat had to wait 20 seconds between lever presses. If the rat was too impulsive and pressed the lever too soon, it had to wait an additional 20 seconds.

Researchers then activated a specific MCH neural pathway from the hypothalamus to the hippocampus, an area of the brain involved with learning and memory function. The results, concluded the researchers, suggested MCH doesn’t affect how much the animals liked the food or how hard they were willing to work for the food. Rather, the circuit acted on the animals’ ability to stop themselves from trying to get the food.

The study provides further evidence of how poorly we regulate our cravings, particularly when the opportunity arises to consume junk food. And when you consider that many of us encounter these overly sweetened foods every day at convenience stores, grocery stores, and elsewhere, the ramifications are concerning.

The connection between food, particularly sugar, and addictive behavior also has been highlighted in popular media. The New York Times recently referenced a study on rats: “Princeton University and University of Florida researchers have found that sugar-binging rats show signs of opiatelike withdrawal when their sugar is taken away—including chattering teeth, tremoring forepaws, and the shakes. When the rats were allowed to resume eating sugar two weeks later, they pressed the food lever so frantically that they consumed 23 percent more than before.” This sentence should be disturbing to readers.

An area of the brain known as the nucleus accumbens is largely responsible for the reward response to food. There has been much research into the possibility that by rewiring this portion of the brain, we can control our weightThe truth is, of course, that we already have control over our decisionsThrough personal responsibility and discipline, we have as much control as we need to make healthier choices. Unfortunately, many of us continue to make poor decisions when it comes to the foods we eat.

Why is that?

While pizza tastes good and can be responsibly consumed periodicallywhen eaten regularly, it can elicit more troubling outcomes. The more rewarding foods we consume, the more likely we are to consume other rewarding foods. This is similar to the phenomenon seen in drug usage, where one drug serves as a gateway drug to stronger substances. Thus, pizza or soda could be seen as gateway foods. Manufacturers are aware of this fact and, indeed, take advantage of that idea.

While using pharmaceuticals to alter our brain activity and reduce cravings has some appeal, there are very serious ethical and moral considerations. For example, is it appropriate to use psychoactive drugs so that some people are less likely to overeat? Do we so deeply lack the self-control needed to reduce obesity rates from that 40percent mark?

Instead, can we simply choose better foods with enormous benefits and virtually no side effects? Some of the best strategies to stay away from addictive foods include using wholesome Paleo recipeschoosing healthier cookbooks, and avoiding processed foods and sugars. If something comes in a can, in a bottle, or in a shrink-wrapped packageodds are you would be better off not eating it. Cooking for yourself is also far cheaper, so doing so will make you healthier and save you money. That’s a true win-win.

By having a planwhether it be diet, exercise, or bothit’s far easier to stay away from addictive foods.




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Photo by Alan Hardman on Unsplash

While there are many popular foods in America, studies have shown that the classic pizza is the most popular. It has had a huge impact on both our dietary habits and our waistlines. [1] Interestingly, pizza has also been studied to be most associated with indicators of addiction. [2] A report by CNN showed that there is a very precise mechanism at play behind the addictive nature of everyone’s favorite carbohydrate source.  Not surprisingly, it’s salt, sugar, and fat—perfectly proportioned—that makes pizza so impossible to resist. [3-7]

As I have noted before in previous articles, food addiction is very real, and very specific. [8-15] That is to say, it is directly related to the fact that the large majority of our modern diet is processed food. But to understand why food addiction is so common today, we must dive into what exactly the term “processed food” means. Simply, it’s food made entirely by humans. Processed foods do not exist in nature; in fact, it’s almost impossible to be truly addicted to any food found in nature. This is not an accident. This is why low-carb cookbooks that focus on real foods tend to help many with weight loss (this is certainly the feedback my cookbook has gotten).

But processed food works differently. As many scientific researchers have noted, food chemists are paid to make some foods irresistible. [16-17] And when I say irresistible, it’s a polite way of saying addictive. That’s quite shocking to read, but not if you’ve been paying attention to big food companies for the last 100 years. Slowly but surely, food manufacturers have increased the amount of sugar, caffeine, salt, fat, and calories in foods. [18] That decision is a cold, economic one, backed by decades of research.

Big food executives know that the more consumers purchase and consume their food, the better off they will be. [19] This means that ramping up the addictiveness is essentially their only long-term option to continue to make higher profits. However, there is a positive side: Due to consumers’ changing habits (largely due to new ideas like The Paleo Diet) and the subsequent increase in demand for healthier foods, big food companies have started to modify what they offer. From a cynical perspective, it seems they are only doing so because there is now money to be made in this segment of the market. Nevertheless, they are providing more nutritious fare.

If one doubts this narrative, all you need to do is take a look at internal documents from soda companies, which call the consumers who drink their products the most “heavy users.” [20] This is the same term that’s used to refer to drug addicts. This is not a compliment, and it’s not an accident. Many executives from Big Tobacco made the leap to the food industry and brought with them deceptive advertising methods and a penchant for unhealthy products. But because addictive, sugary, and obesity-causing food is only chronically toxic, not acutely toxic, it is increasingly difficult to provide meaningful regulation.

The brain’s amygdala is the biological center for food addiction. In this portion of the brain, feelings of happiness are triggered when the right combination and proportions of certain macronutrients are consumed. [21] It is also the area that helps us determine when foods are too cheesy, too salty, or too sugary. Food chemists have figured out how to make foods most palatable and, thus, most addictive along this spectrum of taste. They refer to it as the “bliss point.” [22] If this sounds unsettling, it is.

If you need help reigning in your doughnut consumption, consider the hundreds of lab tests that were performed on that doughnut before it was brought to market. Scientists determined precisely how much sugar to include, for the sole purpose of making you crave another one. This brings us to the addictive and disturbing properties of sugar. It’s simply a white poison, in many respects—albeit one that acts slowly and lacks potency. [23] Nonetheless, it has many disturbing biochemical similarities to alcohol, which is a much more acute toxin. [24] The more sugar we consume, the more we crave it. If we withdraw from sugar, there are withdrawal symptoms. [25]

In fact, some studies have shown that cookies are potentially more addictive than cocaine. [26] While the comparison isn’t particularly fair, one thing is certain: there’s a societal acceptance of both obesity and cookies, whereas cocaine is a social stigma. Yes, the nature of our society makes it okay to eat half of a pizza in one sitting, but not okay to ingest addictive drugs. The truth is that both of these are addictions. It has been interesting to see the obesity pandemic balloon to enormous heights, and simultaneously see the “body positivity” movement take off. [27]

While I have no issue with people having self-esteem, as a personal trainer and nutritionist I’m much more concerned with what obesity is doing to the client’s long-term health. Obesity is, quite literally, deadly.

Which brings us back to that classic slice of pizza.

Let’s break it down and see just how addictive it, as an example of the modern Western diet, can be. Cheese by itself has been shown to be addictive. Add to that bread, which is also addictive. Then throw in some sugar (via sauce) for good measure. It’s the perfect mixture of pleasure for our amygdala.

And let’s not forget the volume of salt in pizza. This is another significant factor in its addictiveness. [28] The CNN report explained how a top sensory scientist has helped companies bring more addictive qualities to pizza, “enhancing” it through food science, to make us want to consumer more of it.

If this sounds a little bit like Darth Vader using the force (i.e. science) for the dark side, you’re right. So, the next time you sit down to have a slice of pizza, think long and hard about how much science went into making it irresistible.



  1. Devine CM, Nelson JA, Chin N, Dozier A, Fernandez ID. “Pizza is cheaper than salad”: assessing workers’ views for an environmental food intervention. Obesity (Silver Spring). 2007;15 Suppl 1:57S-68S.
  2. Schulte EM, Avena NM, Gearhardt AN. Which foods may be addictive? The roles of processing, fat content, and glycemic load. PLoS ONE. 2015;10(2):e0117959.
  3. Schulte EM, Avena NM, Gearhardt AN. Which foods may be addictive? The roles of processing, fat content, and glycemic load. PLoS ONE. 2015;10(2):e0117959.
  4. Koob GF, Volkow ND. Neurobiology of addiction: a neurocircuitry analysis. Lancet Psychiatry. 2016;3(8):760-73.
  5. Volkow ND, Morales M. The Brain on Drugs: From Reward to Addiction. Cell. 2015;162(4):712-25.
  6. Volkow ND, Wise RA, Baler R. The dopamine motive system: implications for drug and food addiction. Nat Rev Neurosci. 2017;18(12):741-752.
  7. Volkow ND, Wang GJ, Tomasi D, Baler RD. Obesity and addiction: neurobiological overlaps. Obes Rev. 2013;14(1):2-18.
  8. Mies GW, Treur JL, Larsen JK, Halberstadt J, Pasman JA, Vink JM. The prevalence of food addiction in a large sample of adolescents and its association with addictive substances. Appetite. 2017;118:97-105.
  9. Ayaz A, Nergiz-unal R, Dedebayraktar D, et al. How does food addiction influence dietary intake profile?. PLoS ONE. 2018;13(4):e0195541.
  10. Novelle MG, Diéguez C. Food Addiction and Binge Eating: Lessons Learned from Animal Models. Nutrients. 2018;10(1)
  11. Eördögh E, Hoyer M, Szeleczky G. [Food Addiction as a new behavioral addiction]. Psychiatr Hung. 2016;31(3):248-255.
  12. Ziauddeen H, Fletcher PC. Is food addiction a valid and useful concept?. Obes Rev. 2013;14(1):19-28.
  13. Gordon EL, Ariel-donges AH, Bauman V, Merlo LJ. What Is the Evidence for “Food Addiction?” A Systematic Review. Nutrients. 2018;10(4)
  14. Gordon EL, Ariel-donges AH, Bauman V, Merlo LJ. What Is the Evidence for “Food Addiction?” A Systematic Review. Nutrients. 2018;10(4)
  15. Volkow ND, Wang GJ, Tomasi D, Baler RD. Obesity and addiction: neurobiological overlaps. Obes Rev. 2013;14(1):2-18.
  16. Penzenstadler L, Soares C, Karila L, Khazaal Y. Systematic Review of Food Addiction as Measured With the Yale Food Addiction Scale: Implications for the Food Addiction Construct. Curr Neuropharmacol. 2018;
  17. Parylak SL, Koob GF, Zorrilla EP. The dark side of food addiction. Physiol Behav. 2011;104(1):149-56.
  18. Avena NM, Rada P, Hoebel BG. Sugar and fat bingeing have notable differences in addictive-like behavior. J Nutr. 2009;139(3):623-8.
  19. Brownell KD, Warner KE. The perils of ignoring history: Big Tobacco played dirty and millions died. How similar is Big Food?. Milbank Q. 2009;87(1):259-94.
  20. Vartanian LR, Schwartz MB, Brownell KD. Effects of soft drink consumption on nutrition and health: a systematic review and meta-analysis. Am J Public Health. 2007;97(4):667-75.
  21. Moore CF, Sabino V, Koob GF, Cottone P. Neuroscience of Compulsive Eating Behavior. Front Neurosci. 2017;11:469.
  22. Spence C, Okajima K, Cheok AD, Petit O, Michel C. Eating with our eyes: From visual hunger to digital satiation. Brain Cogn. 2016;110:53-63.
  23. Stanhope KL. Sugar consumption, metabolic disease and obesity: The state of the controversy. Crit Rev Clin Lab Sci. 2016;53(1):52-67.
  24. Manzo-avalos S, Saavedra-molina A. Cellular and mitochondrial effects of alcohol consumption. Int J Environ Res Public Health. 2010;7(12):4281-304.
  25. Mangabeira V, Garcia-mijares M, Silva MT. Sugar withdrawal and differential reinforcement of low rate (DRL) performance in rats. Physiol Behav. 2015;139:468-73.
  26. Lenoir M, Serre F, Cantin L, Ahmed SH. Intense sweetness surpasses cocaine reward. PLoS ONE. 2007;2(8):e698.
  27. Meldrum DR, Morris MA, Gambone JC. Obesity pandemic: causes, consequences, and solutions-but do we have the will?. Fertil Steril. 2017;107(4):833-839.
  28. Tekol Y. Salt addiction: a different kind of drug addiction. Med Hypotheses. 2006;67(5):1233-4.

The Reality of Food Addiction: Recharged | The Paleo Diet

In one of my post popular articles, I dove deep into the mire of just why so many of us are addicted to food. This subject is fascinating on both a molecular and individual level.1, 2, 3, 4  There are so many factors which go into food addiction.5, 6, 7, 8, 9, 10, 11, 12, 13 And most of them go totally unnoticed, to most people.14, 15, 16, 17, 18, 19, 20, 21, 22 The pervasiveness of advertising, the purposely addictive nature of processed foods, and the stressful nature of modern life is just too much for most of us to stay healthy.23, 24, 25, 26, 27, 28, 29, 30, 31, 32 Of course, new research has emerged on this topic, since an entire calendar year has passed since I wrote my first piece on food addiction – and some of it is quite startling.33, 34, 35, 36, 37, 38, 39, 40,

The Reality of Food Addiction: Recharged | The Paleo Diet

Volkow, Nora D et al. “Overlapping Neuronal Circuits in Addiction and Obesity: Evidence of Systems Pathology.” Philosophical Transactions of the Royal Society B: Biological Sciences 363.1507 (2008): 3191–3200. PMC. Web. 7 Aug. 2015.

But perhaps most troublingly, many scientists are still trying to fight the notion that food addiction even exists.41, 42, 43 I’m alarmed, offended and angry about this continued hemming and hawing (no doubt influenced by industry) – and you should be too. In simplest terms, go ask the average person following a Standard American Diet (SAD) if they feel addicted to food. I would bet everything I own that their answer would be a resounding “yes.”44, 45 No one wants to be obese, and unquestionably some level of addiction is underlying our obesity pandemic.46, 47, 48, 49, 50, 51 52, 53, 54, 55 Certainly there are also other factors, which I’ve also written about, (like leptin resistance) that happen as a result of poor food choices compounded over time.56, 57, 58, 59, 60, 61, 62, 63, 64

The Reality of Food Addiction: Recharged | The Paleo Diet

Agrawal, Rahul, and Fernando Gomez-Pinilla. “‘Metabolic Syndrome’ in the Brain: Deficiency in Omega-3 Fatty Acid Exacerbates Dysfunctions in Insulin Receptor Signalling and Cognition.” The Journal of Physiology 590.Pt 10 (2012): 2485–2499. PMC. Web. 7 Aug. 2015.

The Reality of Food Addiction: Recharged | The Paleo Diet

Cai, Dongsheng, and Tiewen Liu. “Inflammatory Cause of Metabolic Syndrome via Brain Stress and NF-κB.” Aging (Albany NY) 4.2 (2012): 98–115. Print.

It is my generation who is now having to pay for all the poor choices made by prior ones, and now more than 66% of adults are overweight or obese.65 Four years ago researchers knew that “there are a number of shared neural and hormonal pathways…that may help researchers discover why certain individuals continue to overeat despite health and other consequences”.66 And yet, some scientists refuse to even acknowledge people are addicted to food! It is maddening.

The Reality of Food Addiction: Recharged | The Paleo Diet

Sturm, Roland, and Aiko Hattori. “Morbid Obesity Rates Continue to Rise Rapidly in the US.” International journal of obesity (2005) 37.6 (2013): 889–891. PMC. Web. 7 Aug. 2015.

The results of food addiction are happening here and now.67, 68 We see them every day on the way to work, at the store, in society, and even glamorized in popular media. Certainly, no one should be ‘fat shamed’ – but we shouldn’t be celebrating obesity either. Food addiction is just as sad as drug addiction – it is just destructive over a longer period of time, rather than acutely.69, 70, 71 As science shows, the same neurobiological pathways that are implicated in drug abuse also modulate food consumption.72, 73

The Reality of Food Addiction: Recharged | The Paleo Diet

Volkow, Nora D et al. “Overlapping Neuronal Circuits in Addiction and Obesity: Evidence of Systems Pathology.” Philosophical Transactions of the Royal Society B: Biological Sciences 363.1507 (2008): 3191–3200. PMC. Web. 7 Aug. 2015.

The Reality of Food Addiction: Recharged | The Paleo Diet

Volkow, Nora D et al. “Overlapping Neuronal Circuits in Addiction and Obesity: Evidence of Systems Pathology.” Philosophical Transactions of the Royal Society B: Biological Sciences 363.1507 (2008): 3191–3200. PMC. Web. 7 Aug. 2015.

The Reality of Food Addiction: Recharged | The Paleo Diet

Baik, Ja-Hyun. “Dopamine Signaling in Food Addiction: Role of Dopamine D2 Receptors.” BMB Reports 46.11 (2013): 519–526. PMC. Web. 7 Aug. 2015.

Or how about the scientific paper which showed that Oreo cookies were as addictive as cocaine?74 Again, you will find some scientists hemming and hawing, but the reality, the way the science translates into our everyday lives, shows clear addiction. Do you feel like you need to eat the whole bag of broccoli? Obviously not. For most, vegetables are a chore. But it sure is easy to eat a whole box of Oreos! In fact, many find it hard not to.75 Does this sound addictive to you?

Then we have the case of researchers “curing binge eating” by modulating dopamine receptors.76 Why is this notable? Because by altering the brain’s response to rewarding food, we can stop the cravings/addiction! This really hammers home the point that food can be addictive, and that it is not just an innocent bystander that some people (66% of all adults, if you’re keeping track) can’t seem to stop consuming. If you wants to know more of the deep molecular mechanisms and psychology behind eating, I have also written on this very subject.

The Reality of Food Addiction: Recharged | The Paleo Diet

Green, Erin, and Claire Murphy. “Altered Processing of Sweet Taste in the Brain of Diet Soda Drinkers.” Physiology & behavior 107.4 (2012): 560–567. PMC. Web. 7 Aug. 2015.

And what is one of the most addictive, and least healthy habits in the world? Soda. The less soda you drink, the great weight loss you see.77, 78, 79 Even artificial sweeteners have shown rewarding mechanisms in the brain.80, 81, 82, 83, 84 Interestingly, new research has shown that a hormone deficiency in the brain may also be causing overeating.85, 86, 87 This is in addition to new research which shows that ‘bad’ genes may also play a role in overconsumption.88, 89, 90, 91, 92

Clearly, food addiction is a real problem, which needs to be fixed as soon as possible.93, 94 The future of (a healthy) human world…sort of depends on it. A Paleo diet is one of the best ways to go cold turkey, and stop food addiction in its tracks. By eating nutrient dense foods, sleeping soundly, and managing stress, we are taking proactive steps to avoiding food addiction and obesity.95, 96 97, 98, 99, 100




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Not So (Artifically) Sweet | The Paleo Diet

I have had countless clients try to replace their sugar-laden diets with ones rich with artificial sweeteners. While this may work in the short term, it definitely does not work in the long term.1 2 And, the reasons for this are countless.3,

New research shows sugars specifically activate six neurosecretory cells in the brain, which produce Dh44, a homolog of the mammalian corticotropin-releasing hormone.4, 5 Artificial sweeteners do not activate these same cells – possibly leaving the brain in a half-finished reward state – potentially leading to more calories being taken in.6, 7

Not So (Artificially) Sweet | The Paleo Diet

Yang, Qing. “Gain Weight by ‘going Diet?’ Artificial Sweeteners and the Neurobiology of Sugar Cravings: Neuroscience 2010.” The Yale Journal of Biology and Medicine 83.2 (2010): 101–108. Print.

Another issue with artificial sweeteners is they are typically much, much sweeter than sugar. Just how much sweeter are these manmade creations? Most artificial sweeteners are 200-400 times sweeter than regular table sugar!8 Many researchers argue this leaves the brain expecting a plethora of calories, and also disrupts the brain’s natural reward mechanisms.9

While followers of the Paleo diet will certainly know that artificial sweeteners have no place in a healthy lifestyle, many who are trying to change their eating habits rely on artificial sweeteners for brief time periods. Not a great idea. As the scientific literature suggests, artificial sweeteners (because they are sweet) encourage sugar craving and sugar dependence.10

Even stevia, which many will argue is a healthier alternative to most artificial sweeteners, is 100-300 times sweeter than table sugar!11 It is certainly not a good idea to be consuming something that sweet on a regular basis – whether it contains sugar or not. Furthermore, artificial sweeteners are typically packaged in foods or drinks that have a laundry list of other negative substances and artificial ingredients.12

Salient scientific studies clearly show how in repeatedly exposing ourselves to sugar, we help to train our flavor preference. In short – the more sweet we eat, the more we crave and expect it. Many studies have shown lowering fat and/or salt intake, over several weeks, leads to less craving of these elements. This is exactly how you should treat sugar and artificial sweeteners.

Not So (Artificallyy) Sweet | The Paleo Diet

Sclafani, Anthony. “Sweet Taste Signaling in the Gut.” Proceedings of the National Academy of Sciences of the United States of America 104.38 (2007): 14887–14888. PMC. Web. 7 July 2015.

On a granular level, T1R2 and T1R3 sweet taste receptors are found in taste cells in the mouth and enteroendocrine cells in the gut.13 Stimulation of the T1R2 and T1R3 receptors in the mouth by sugars and artificial sweeteners activates intracellular signaling elements, which trigger peripheral taste nerves and brain gustatory pathways. This is one way in which artificial sweeteners actually have a similar effect to sugar – which is not a good thing.

Moreover, research shows substituting sucrose-sweetened drinks for diet drinks does not reduce total energy intake – and may even result in a higher intake during the following day.14 Artificial sweeteners are not the answer.

Even back in 1986, researchers concluded that the data do not support the hypothesis that long-term artificial sweetener use either helps weight loss or prevents weight gain.15

Not So (Artifically) Sweet | The Paleo Diet

Fernstrom, John D. et al. “Mechanisms for Sweetness.” The Journal of Nutrition 142.6 (2012): 1134S–1141S. PMC. Web. 7 July 2015.

So why are artificial sweeteners still used? Well, quite simply: money and industry.

Artificial sweeteners are beneficial to the food industry for a variety of reasons. One – they are cheap, and can help make poor quality foods taste ‘better’. Two – it makes it seem like they care. They sell you the sugar-laden stuff, and then – if you are ‘health conscious’ – you can buy their artificially sweetened product instead. Either way – they win.

I may be preaching to the converted here on The Paleo Diet, but often times even the most disciplined of us slowly let little ‘cheats’ into our diet – without realizing the long term impacts these seemingly innocuous choices may be having on our bodies and brains. If we have any hope of getting out of the current obesity pandemic we currently find ourselves in, it starts with removing all the sweetness (artificial or not) from our collective diet.16, 17, 18, 19, 20, 21 Your health (and waistline) will thank you for it!



[1] Feijó Fde M, Ballard CR, Foletto KC, et al. Saccharin and aspartame, compared with sucrose, induce greater weight gain in adult Wistar rats, at similar total caloric intake levels. Appetite. 2013;60(1):203-7.

[2] Bellisle F, Drewnowski A. Intense sweeteners, energy intake and the control of body weight. Eur J Clin Nutr. 2007;61(6):691-700.

[3] Suez J, Korem T, Zeevi D, et al. Artificial sweeteners induce glucose intolerance by altering the gut microbiota. Nature. 2014;514(7521):181-6.

[4] Available at: //www.endocrinologyadvisor.com/neuroendocrinology/sugar-artificial-sweeteners-satiety/article/423644/. Accessed July 5, 2015.

[5] Dus M, Lai JS, Gunapala KM, et al. Nutrient Sensor in the Brain Directs the Action of the Brain-Gut Axis in Drosophila. Neuron. 2015;87(1):139-51.

[6] Fowler SP, Williams K, Resendez RG, Hunt KJ, Hazuda HP, Stern MP. Fueling the obesity epidemic? Artificially sweetened beverage use and long-term weight gain. Obesity (Silver Spring). 2008;16(8):1894-900.

[7] Blundell JE, Hill AJ. Paradoxical effects of an intense sweetener (aspartame) on appetite. Lancet. 1986;1(8489):1092-3.

[8] Pandurangan M, Park J, Kim E. Aspartame downregulates 3T3-L1 differentiation. In Vitro Cell Dev Biol Anim. 2014;50(9):851-7.

[9] Fernstrom JD, Munger SD, Sclafani A, De araujo IE, Roberts A, Molinary S. Mechanisms for sweetness. J Nutr. 2012;142(6):1134S-41S.

[10] Yang Q. Gain weight by “going diet?” Artificial sweeteners and the neurobiology of sugar cravings: Neuroscience 2010. Yale J Biol Med. 2010;83(2):101-8.

[11] Goyal SK, Samsher, Goyal RK. Stevia (Stevia rebaudiana) a bio-sweetener: a review. Int J Food Sci Nutr. 2010;61(1):1-10.

[12] Kellett GL, Brot-laroche E, Mace OJ, Leturque A. Sugar absorption in the intestine: the role of GLUT2. Annu Rev Nutr. 2008;28:35-54.

[13] Sclafani A. Sweet taste signaling in the gut. Proc Natl Acad Sci USA. 2007;104(38):14887-8.

[14] Lavin JH, French SJ, Read NW. The effect of sucrose- and aspartame-sweetened drinks on energy intake, hunger and food choice of female, moderately restrained eaters. Int J Obes Relat Metab Disord. 1997;21(1):37-42.

[15] Stellman SD, Garfinkel L. Artificial sweetener use and one-year weight change among women. Prev Med. 1986;15(2):195-202.

[16] Swinburn BA, Sacks G, Hall KD, et al. The global obesity pandemic: shaped by global drivers and local environments. Lancet. 2011;378(9793):804-14.

[17] Soeliman FA, Azadbakht L. Weight loss maintenance: A review on dietary related strategies. J Res Med Sci. 2014;19(3):268-75.

[18] Lustig RH. Fructose: metabolic, hedonic, and societal parallels with ethanol. J Am Diet Assoc. 2010;110(9):1307-21.

[19] Isganaitis E, Lustig RH. Fast food, central nervous system insulin resistance, and obesity. Arterioscler Thromb Vasc Biol. 2005;25(12):2451-62.

[20] Lustig RH, Sen S, Soberman JE, Velasquez-mieyer PA. Obesity, leptin resistance, and the effects of insulin reduction. Int J Obes Relat Metab Disord. 2004;28(10):1344-8.

[21] Lustig RH. The neuroendocrinology of obesity. Endocrinol Metab Clin North Am. 2001;30(3):765-85.

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