Singapore

All’s not so sweet when you’re hooked on sugar

All’s not so sweet when      you’re hooked on sugar
In Singapore, an average person consumes more than 1,500 teaspoons of sugar from pre-packaged sugared drinks every year, according to the Health Ministry. Photo: The New York Times
Effects of excess sugar on brain similar to addictive substances, according to some local experts
Published: 4:00 AM, August 30, 2017
Updated: 3:17 AM, September 3, 2017

SINGAPORE — Like clockwork, the insatiable craving for sugar used to hit 55-year-old security supervisor A Jeyaseelan every day at 7.30am, 2pm and 6pm. Without his fix of coffee with dollops of condensed and evaporated milk, withdrawal symptoms such as a headache, lethargy and agitation would kick in and “everyone in sight would get a scolding”.

Despite having multiple chronic diseases including diabetes and high cholesterol, cakes, pastries, canned fruits and sweetened drinks were Mr Jeyaseelan’s daily staples. He drank at least five cans of soft drinks daily, or as much as one can per hour.

“When I tried to cut down on my sugar intake in my coffee (due to poor health), I really suffered. I couldn’t understand why the craving and withdrawal symptoms were so bad — it was just a cup of coffee but I felt like the addicts I saw on TV,” he said.

Mr Jeyaseelan’s dependence on sugar is not unheard of in Singapore, where an average person consumes more than 1,500 teaspoons of sugar from pre-packaged sugared drinks every year, according to the Health Ministry. Sugar is naturally found in food such as fruit, vegetables and dairy products.

The body needs sugar to function properly, and can easily get the eight to 11 teaspoons it needs daily from natural food sources, said nutritionist Wendy Riddell of Ufit, which offers fitness, nutrition and sports rehabilitation programmes.

But most of the people Ms Riddell sees consume an estimated 30 teaspoons per day, of which the majority are from refined sugar and corn, or fructose syrup, added to processed food and drinks.

 

SUGAR-LADEN, BUT SO TASTY

 

Foods with added sugars tend to be among the tastiest, most affordable, varied and most convenient types of food available, said Professor Eric Finkelstein from the Health Services and Systems Research Programme at Duke-NUS Medical School.

“Although consumers are generally aware they are not healthy, the disconnect between their current consumption and future health is so large people tend to overlook the health implications when consuming such foods,” he said.

Some experts TODAY spoke to believe this “disconnect” is not due to just a lack of willpower or health awareness, but something more complex at work: The individuals may be hooked on sugar.

Debate on whether added sugars in food could be addictive in the same way as, say, alcohol and drugs, has gone on for years.

Unlike binge-eating, food or sugar addiction is currently not recognised as an official eating disorder in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders by the American Psychiatric Association.

Yet, the effects of excess sugar on the brain are similar to addictive substances, said some local experts who have observed an increasing number of people seeking help to reduce their high sugar intake.

At present, the Yale Food Addiction Scale is the only tool available to assess food addiction in individuals.

Foods most identified by the scale to cause addiction are typically high in sugar.

They tend to be the most problematic for clients that clinical psychologist and addiction therapist Eleanor Ong of The Cabin Singapore has seen for food dependency issues.

Since last year, The Cabin Singapore saw 10 people with such issues, three of whom were referred to a nutritionist for sugar detoxification and a diet overhaul. Before that, its addiction counsellors did not see such cases.

“Some of them may go through several tubs of ice-cream or 10 bars of chocolate in a go. They are unable to abstain from food like ice-cream and fizzy drinks despite the negative consequences. Another tell-tale sign (of any food addiction) is that they try to hide their behaviour — there is a lot of shame involved,” said Ms Ong.

Many will attempt to quit their high sugar intake on their own but often fail, when withdrawal symptoms like mood swings and irritability kick in.

In some cases, their progressive sugar dependence is intertwined with other behavioural issues such as binge-watching of television programmes or compulsive gaming, said Ms Ong.

Ufit has seen a 12-fold increase in the number of participants in its Clean and Lean Challenge, a four-week nutrition programme that includes stripping unwanted sugars from the diet.

When the challenge was launched four years ago, it ran twice a year, with about 12 participants each time. It now runs five times a year with an average of 150 participants per run. After festive seasons, the number can hit 300, said Ms Riddell, who is also the director of boot camps and a personal trainer at Ufit.

“People are starting to take an interest in their health. But (more people are signing up) also because it can be very difficult to break a sugar addiction on their own,” she said.

High blood sugar over a sustained period of time puts a strain on the body, leading to obesity insulin resistance and, ultimately, diabetes, said Dr Ben Ng, consultant physician and endocrinologist at Arden Endocrinology Specialist Clinic.

In diabetics, it damages nerves, blood vessels and organs, which contributes to complications such as blindness and kidney damage.

People who consume a lot of sugar tend to overeat because, unlike high-protein or high-fat foods, a high-sugar diet impairs the body’s ability to feel full, said Ms Riddell.

High blood sugar levels cause the brain to become intolerant to a hormone known as leptin, also known as the satiety hormone. “Sugar tells the brain, ‘Oh, this tastes nice’, and the person ends up eating more than necessary,” she said.

The quick release of neurotransmitters such as dopamine after consuming a high amount of sugar also results in the person feeling ‘‘good” for a short period of time, said Dr Ng.

“The problem with this sugar rush … is that it could result in a sugar ‘addiction’ in the long term. Repeated exposure blunts the neurotransmitter response, and the person needs more and more sugar to get the same feel-good effect,” he said.

 

DON’T START THEM YOUNG

 

For this reason, Ms Riddell warned parents against starting their children early on high-sugar foods.

“Excessive sugar consumption may not show in their bodies yet, but once children get started on the habit, it’s going to be hard to get rid of it,” she said.

Ms Ong believes it is not sugar itself that causes the addictive behaviour, but a person’s relationship with it.

Studies have shown that comfort- eating, poor diet and lifestyle choices tend to increase when people are stressed or worn out, added Dr Ng.

“The same food item won’t pose a problem to someone with a healthy relationship with food. I believe a lot of the food addiction behaviours stem from growing up in an environment where food is used as a soothing mechanism,” said Ms Ong.

She advised those who have trouble cutting down on their high sugar intake to seek professional support.

“Eating is not something you can stop doing completely. With drugs or alcohol, you can (go cold turkey) but what do you do with food? We usually recommend our clients see a nutritionist together with their counselling sessions. Those who do usually have a better chance of dealing with it,” added Ms Ong.

For Mr Jeyaseelan, a near-fatal health scare five years ago hardened his resolve to cut down on sugar as well as food portions. After a heart bypass, severe complications set in due to his poorly managed blood sugar levels and other health issues.

“I experienced poor healing and my sternum (breastbone) had to be removed due to the complications. I spent four months in hospital. That was my wake-up call. But my sugar cravings at the time were so bad that I could not cut down on my intake even though I knew it would eventually kill me,” he said.

Five years on, with support from his doctor, Mr Jeyaseelan has drastically cut down on his coffee and condensed milk intake. Canned drinks are now a monthly indulgence. This week, he will also start using a Flash Glucose Monitoring system, which includes a sensor worn on the arm that is wirelessly connected to a touchscreen device, to maintain his blood sugar more effectively.

“I don’t want to go blind or lose my toes to diabetes. Eventually, I intend to totally cut out added sugar from my coffee. Strangely, I feel so much more energetic now that I’ve cut down on my sugar intake and food portions,” he said.