Why Are We Consuming So Much Sugar Despite Knowing Too Much Can Harm Us?—Reply

We appreciate the suggestion by Avena and colleagues that addiction-like behaviors and related brain changes may perpetuate overeating highly palatable foods that tend to contain high amounts of added sugars. This interesting hypothesis needs to be tested in well-designed interventions and mechanistic studies. Although the high consumption of added sugars in the US population (on average, approximately 22 teaspoons per day) is possibly related to the “addictive” property of the palatable foods and the reward system in the brain, the abundance of added sugars in the current food environment and influential advertising by the food industry may also play an important role.1 Our data indicate that the majority of US adults consumed more added sugars than is recommended for a healthy diet. Our results, along with the findings of many other studies,2–5 support current recommendations to reduce the intake of added sugars in US diets.6