We all know that we can’t put down our sweet drinks or our mobile phones. What if these cravings are engineered – by design? And what if these desires actually cause damage – not just to ourselves, but to our families, our friends, and our entire society?

While researching the toxic impact of sugar on our health for his bestseller Fat Chance Robert Lustig MD, MSL, made a discovery that reaches beyond the politics of food. Our seemingly innocent addictions are far from it - they are biochemical, and they are damaging our bodies and our brains. Lustig reveals how these chemicals interact with one another to drive our behaviours, and how Big Business uses the science of addiction to keep us hooked – to our detriment, and their profit.

Dopamine is the “reward” neurotransmitter that tells our brains “This feels good, I want more.” Yet too much dopamine leads to addiction. Serotonin is the “contentment” neurotransmitter that tells our brains “This feels good, I have enough”. Yet too little serotonin leads to depression. Ideally, both should be in optimal supply. Too many of our simple pleasures have morphed into something else – an afternoon with friends has been replaced by 1,000 friendings on Facebook.

Robert Lustig is a professor of paediatrics in the Division of Endocrinology and a member of the Institute for Health Policy Studies at the University of California, San Francisco. The substance that got him started on thinking about nutrition, health, disease, and how our emotions are manipulated – the substance that revealed its hidden iniquities to him back in 2006 – is sugar. It was the science of sugar that showed him the behaviours associated with obesity (gluttony and sloth) were in fact due to a change in biochemistry, and that the biochemistry was due to a change in the environment.  Fat Chance is a treatise on the science of obesity and metabolic syndrome, and the implications that the science portends for people and policy. But it was understanding the brain science that allowed him to put the data together to form a unifying hypothesis, and that sparked the impetus for his efforts to educate the public – to debunk the myths surrounding the obesity epidemic, which had prevented policymakers from addressing the deficiencies of the toxic food environment, rather than ineffectively trying to modulate behaviours that are the result of that biochemistry. This meant he needed to know the law surrounding public health in order to understand and impact policy. So, 30 years after qualifying in medicine he went to law school.

In his latest book The Hacking of the American Mind[ii] he also uses biochemistry to educate the reader about the toxic environment in which we currently find ourselves – and perhaps even more importantly, how we remain there. He says that it’s not about personal responsibility, but only we can help ourselves because no one else will. Because pleasure and happiness, for all their apparent similarity, are separate phenomena, and in the extreme function as opposites. In fact, pleasure is the slippery slope to tolerance and addiction, while happiness is the key to long life.

He describes seven differences between reward and contentment:

Lustig shows that in the last half century, America and most of the Western world have become more and more unhappy, sicker, and broke as well. Marketing, media, and technology capitalise on subverting brain physiology to their advantage in order to veer us away from the pursuit of happiness to the pursuit of pleasure, which for them of course equals the pursuit of profit. Fuelling our quest for reward has only contributed to the epidemics of non-communicable diseases such as diabetes, heart disease, cancer, dementia, which are eating away at our health, our healthcare system, and the fabric of our society.

Lustig describes how the United States is home to both individual rights and corporate rights. The balance of power between individuals and corporations has always been precarious. There have been many attempts where corporations have tried to tip the scale to usurp control over individual rights but in each successive era the scale has been rebalanced by the political process. The Sherman Anti-Trust Act in 1890 helped beat back the threat of monopolisation by the robber barons and in the early 1900s Teddy Roosevelt was able to effectively constrain growth in corporations and banks. After the squalour and danger of slaughterhouses in the meat industry were laid bare by Upton Sinclair in The Jungle (1906), Congress was pressured to charter the FDA to protect the nation’s food supply. There are many more such examples all the way up to the establishment of the Environmental Protection Agency and the Occupational Safety and Health Administration in 1970.

But since 1971 there has been a slow, ever-steady creep of usurpation of power by corporations, with a concomitant loss of power from individuals. There is not room in this blog to list all the evidence that Lustig provides for this. But he is certainly not making a left wing versus right wing point; more a point about the state helping corporations exploit the individual whether it be by allowing the pharmaceutical industry to harness fear to create demand for their products; allowing corporations to turn their treasuries into campaign war chests to bankroll any candidate to do their bidding; promoting protecting commercial speech from unwanted governmental regulation so corporations could sell poison to the public, as long as people are dying in the streets government is quiet. Tobacco was a good example.

Hence the title of his book The Hacking of the American Mind, and I have changed that title in my blog to 'the Western Mind’ as much of this applies throughout the Western world. But in the final part of the book Lustig gives us, if not a solution to the overall problem, a way to make it better for yourself as an individual. He recommends the four Cs of Contentment: Connect, Contribute, Cope, and Cook. The rationale for each is supported by the documented neuroscientific effects on our three limbic system pathways – the reward pathway, the contentment pathway, and the stress-fear-memory pathway. When used properly, each has been proven to be clinically effective on its own and even more so together. You can perform any or all of these – without a prescription, without a personal trainer, without cost, and at home. But there are two caveats to their efficacy:

Connect: (Religion, Social Support, Conversation). There are many ways that people can connect. Some do it through their religious activities. People find contentment in being part of the community, it evinces social relationships. Social support correlates with positive emotions, greater reward activation, and increases in serotonin. Conversely, low social support correlates with negative emotions such as hostility, less reward for social stimuli as well as low serotonin. Performing acts of compassion, like visiting a sick friend or relative, provides a powerful sense of connection and is a prime promoter of emotional well-being and contentment.,
But this connection must be in person. It does not work on social networks. They do not provide contentment.  Lustig works with children. The ones he sees in his clinic are the ones who prefer to text than talk, can only communicate through Snapchat and won’t make eye contact. They are the ones whose iPads have assured that they have never had, and never will have, a dull moment. And that’s a whole lot of unhappiness.

Contribute: (Altruism, Volunteerism, Philanthropy). One easy way to increased contentment and derive health benefits is volunteerism. By offering your spare time to a cause bigger than yourself, without thought of personal gain, you can derive meaningful contentment. Those who volunteer have a larger face-to-face social network and more opportunity to derive a sense of contribution and purpose but if you don’t have the time to make the world a better place yourself, pay someone to do it for you. It’s not the same thing but it still works. Winston Churchill, brought up with all the advantages money had to offer, famously said, “We make a living by what we get, but make a life by what we give.”

Cope: (Sleep, Mindfulness, Exercise). One of the primary drivers of reward and inhibitors of contentment is stress. Yet it’s not the specific stressor that matters, it’s the individual’s response to stress and how long it goes on that determines whether that particular stress is adaptive or maladaptive. Someone once told me that the absence of stress is distress. Some stress is good such as running an athletic race but high demands at work or caring for a parent with dementia is bad stress. There are few if any benefits to be had, and there is no expectation of being happy.

Sleep is essential to optimising serotonin and mood. The brain after a good night’s sleep processes information differently than a sleep deprived brain. Chronic sleep deprivation results in increased dopamine and reduced serotonin. Stress impedes duration and quality of sleep, which leads to more stress.

A lot of stress comes from our screens – and not just the blue light that gives us insomnia. Full-blown internet addiction is particularly worrisome and even life-threatening. Multi-tasking has taken on a new meaning in the era of the internet and mobile devices and the combination of these two technologies has shot this practice through the roof. Adults who engage in multi-tasking find themselves increasingly stressed.

Doctors have known for decades that exercise is the single best thing you can do yourself, both physically and mentally.

Cook: (For yourself, Your friends, Your family). If we consciously removed sugary drinks, sweets, cakes and ice cream from our homes and our diet, we would still be well over recommended limits as only 51% of sugar in our diet is in the food you’d expect. That means 49% of sugar we consume is in foods and drinks that we didn’t know had sugar like salad dressing, barbecue sauce, hamburger buns, hamburger meat, smoked salmon, as well as so-called healthy options like granola and muesli. As for fruit juice Rustig describes that as basically just sugar without the fibre. Sugar adds bulk. It makes food brown; the browning of bananas is called the Maillard or “browning” reaction. That reaction is happening inside yourselves all the time and when it does proteins unravel and free radicals form which further damages cells. The Maillard reaction has another name, the ageing reaction. Sugar raises the boiling point. This allows for caramelisation to occur, which is very tasty, but again this is just the Maillard reaction. Sugar is a humectant (it attracts and maintains moisture). Fresh bakery bread becomes stale in two days. The commercial bread that supermarkets sell may take up to 3 weeks because the baker adds sugar to take the place of water. Sugar doesn’t evaporate but it helps preserve.

Processed food is addictive, can make you extremely unhappy, and may ultimately kill you.  Lustig closes this book with what he regards “as the single most important key to happiness: COOK REAL FOOD FOR YOURSELF AND YOUR FRIENDS AND YOUR FAMILY! Its connection as it will be sitting down with people you like (and maybe even love); it’s contribution because you’re making something worthwhile; it’s focusing so it’s easier to cope, and unless you spike it with something it’s non-addictive.”

Those who abdicate happiness for pleasure will end up with neither. The science says so.