Research
Original Research
Decreasing the Consumption of Foods with Sugar Increases Their Reinforcing Value: A Potential Barrier for Dietary Behavior Change

https://doi.org/10.1016/j.jand.2018.12.016Get rights and content

Abstract

Background

The Dietary Guidelines for Americans (DGA) have recommended reducing added sugar intake since its inception in 1980. Nearly 40 years later, added sugar consumption still exceeds 2015-2020 DGA recommendations among most of the population. The reinforcing value of food influences eating behaviors, and foods high in added sugars are highly reinforcing. Restricting intake of foods high in added sugars as part of a low-sugar diet may increase their reinforcing value such that reducing consumption may be difficult to maintain. If so, this would present a mechanistic barrier to making the necessary dietary changes to meet 2015-2020 DGA recommendations.

Purpose

To determine whether the relative reinforcing value of foods high in added sugars is altered when reducing intake of all foods high in sugars.

Methods

Obese (n=19) and normal weight (n=23) men and woman who habitually consumed over 10% of their calories from added sugars completed the study. Reinforcing value of foods high in added sugars was measured via progressive ratio schedules of reinforcement before and on day 7 of a weeklong controlled feeding intervention where added sugars comprised 2.5% to 4.0% of daily calories and total sugars 7.3% to 8.6% of daily calories.

Results

The reinforcing value of foods high in added sugars increased (P<0.01) after consuming a diet low in total added sugars for 1 week in both obese and normal weight participants.

Conclusion

Adhering to a low-sugar diet for 1 week increases the reinforcing value of foods high in added sugars. Future studies should examine whether consuming a diet low in added sugars, but not other sugar, increases reinforcing value of foods high in added sugars and whether high–added sugar food reinforcement returns to baseline after longer-term reductions in added sugars.

Section snippets

Design

A pre-post study design was employed. Initial screening visits were used to determine study eligibility. Questionnaires, resting metabolic rate (RMR), and pretreatment RRVsugars were completed on subsequent visits prior to a 7-day dietary intervention designed to reduce daily intake of sugar to <10%. Participants were classified as normal weight (BMI=18.5 to 24.9) or obese (BMI≥30). All participants received the same 7-day diet intervention. Post-treatment RRVsugars was completed on the final

Results

As expected, the normal weight group had a lower (P<0.001) body weight and BMI than the obese group (Table 2). Participants endorsed a slightly greater liking of sweet foods (mean=9.95; SD=1.38) than savory foods (mean=9.05; SD=2.24) (P=0.010), but the absolute difference was small and liking scores were correlated (r=0.36, P=0.0178). Baseline RRVsugars did not differ across BMI (P>0.20). Obese participants were slightly, but significantly older than normal weight participants (Table 2).

Discussion

The current study is the first to assess whether an imposed restriction of a specific type of food (foods high in sugars) to promote a healthy eating pattern that meets the 2015-2020 DGA increases the RRV of the restricted food. The present study extends the literature by being the first to demonstrate that reducing foods high in sugars for 1 week increased RRVsugars by 33%. Such an increase in the RRVsugars could actually lead to greater initial intakes than before the restriction of the less

Conclusions and Future Directions

The consistent recommendations in the DGA across decades to lower added sugar intake without a population change points to the difficulties Americans have had in reducing added sugar intake.4, 5, 6 The current investigation establishes for the first time that following sugar-restricted diet for 1 week results in an increase in RRVsugars in adults, which may act as a barrier for reducing the consumption of these very reinforcing foods.9, 12, 13, 14 Reinforcement for sweet taste may be an

K. D. Flack is an assistant professor, Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, KY; at the time of the study, he was a molecular biologist, Grand Forks Human Nutrition Research Center, Agricultural Research Service, Grand Forks, ND.

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    K. D. Flack is an assistant professor, Department of Dietetics and Human Nutrition, University of Kentucky, Lexington, KY; at the time of the study, he was a molecular biologist, Grand Forks Human Nutrition Research Center, Agricultural Research Service, Grand Forks, ND.

    K. Ufholz is a research psychologist, Grand Forks Human Nutrition Research Center, Agricultural Research Service, Grand Forks, ND.

    S. Casperson is a research biologist, Grand Forks Human Nutrition Research Center, Agricultural Research Service, Grand Forks, ND.

    L. Jahns is a research nutritionist, Grand Forks Human Nutrition Research Center, Agricultural Research Service, Grand Forks, ND.

    L. Johnson is a statistician, Grand Forks Human Nutrition Research Center, Agricultural Research Service, Grand Forks, ND.

    J. N. Roemmich is center director, Grand Forks Human Nutrition Research Center, Agricultural Research Service, Grand Forks, ND.

    STATEMENT OF POTENTIAL CONFLICT OF INTEREST No potential conflict of interest was reported by the authors. The mention of trade names, commercial products, or organizations does not imply endorsement from the US government. USDA is an equal opportunity provider and employer.

    FUNDING/SUPPORT This work was funded by the US Department of Agriculture. The study was approved by the University of North Dakota Institutional Review Board and registered under ClinicalTrials.gov NCT02744001.

    AUTHOR CONTRIBUTIONS K. D. Flack, S. Casperson, L. Jahns, and J. Roemmich designed the study. K. D. Flack and K. Ufholz collected the data. K. D. Flack, K. Ufholz, and L. Johnson analyzed the data. K. D. Flack and K. Ufholz drafted the manuscript, with substantial contributions from other authors. All authors have approved the final version.

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