Toxic Sugar: Should We Regulate It Like Alcohol?

Should sugar be regulated like alcohol? That's the premise of a new position paper, published today in the journal Nature by three leading obesity researchers from the University of California, San Francisco School of Medicine.

They argue that added sugar in all forms -- sucrose and high-fructose corn syrup alike -- is as perilous to public health as a controlled substance like alcohol. Bolstering their argument with statistics on obesity and other chronic disease, as well as evidence that our bodies process sugar in a way that is harmful to our health, they advocate for regulation to temper sugar consumption worldwide.

The researchers' main impetus came from a 2010 United Nations report revealing, for the first time, that more people are dying from chronic, non-communicable diseases, so-called "lifestyle diseases" like heart disease, than from infectious disease. "The UN announcement targets tobacco, alcohol and diet as the central risk factors in non-communicable disease," wrote the researchers. "Two of these three -- tobacco and alcohol -- are regulated by governments to protect public health, leaving one of the primary culprits behind this worldwide health crisis unchecked."

The paper's lead author, pediatric endocrinologist Dr. Robert Lustig, is well known for this line of argument, most notably in his popular lecture, "Sugar: The Bitter Truth" -- a YouTube phenomenon with close to 2 million hits. It's rare that a medical researcher achieves world-wide renown -- or that an endocrinology lecture goes viral, for that matter -- but his argument is a compelling one. He explains that our bodies process fructose in much the same way they process alcohol and other poisons. Sugar isn't just a source of empty calories, responsible for obesity and Type 2 diabetes, in this scenario: at high quantities, it is a full-fledged toxicant and contributes to many of the major fatal non-communicable conditions, like cardiovascular disease and cancer.

Explained Gary Taubes in a New York Times Magazine cover story in April of 2011 on the subject:

The fructose component of sugar and H.F.C.S. is metabolized primarily by the liver, while the glucose from sugar and starches is metabolized by every cell in the body. Consuming sugar (fructose and glucose) means more work for the liver than if you consumed the same number of calories of starch (glucose). And if you take that sugar in liquid form -- soda or fruit juices -- the fructose and glucose will hit the liver more quickly than if you consume them, say, in an apple (or several apples, to get what researchers would call the equivalent dose of sugar). The speed with which the liver has to do its work will also affect how it metabolizes the fructose and glucose.

"It's not about the calories," Lustig is quoted in the New York Times Magazine as saying. "It has nothing to do with the calories. It's a poison by itself."

Now, in this new position paper Lustig and his colleagues, Laura A. Schmidt and Claire D. Brindis, take the argument a bit further. They apply criteria used to justify the control of alcohol (pervasiveness, toxicity, potential for abuse and negative impact on society) to sugar. Not only is sugar toxic in high doses, they argue, high doses are unavoidable in modern society. They write:

Evolutionarily, sugar as fruit was available to our ancestors for only a few months a year (at harvest time), or as honey, which was guarded by bees. But in recent years, sugar has been added to virtually every processed food, limiting consumer choice. Nature made sugar hard to get; man made it easy. In many parts of the world, people are consuming an average of more than 500 calories per day from added sugar alone.

They recommend implementing stopgaps to sugar access -- strategies like enacting sugar taxes, placing age limits on food purchases and limiting advertising of sugar-sweetened foods.

Do you agree? Should we control added sugar? Let us know in the comments.

For more, here are the paper's authors in conversation:

Comments

[Ian Elliot]

10:41 AM on 05/08/2012

Absolutely not! Carbohydrates are an essential part of human diet, unless you want ketoacidosis (you don't) Regulation will just make it harder to obtain a dietary substance. Remember it's the moderation of the user is key. I think we should start instead with ending that pesky war on drugs and bring heroin, pot, LSD, mescaline, amphetamines, etc. to the regulated market for recreational market for responsible adults.

[Jason Kroening-Roche]

07:00 PM on 03/01/2012

I am organizing a campaign in support of Massachusetts House Bill 1697 to eliminate the sales tax exemption on soda and candy in the state. If you are interested in learning more or joining, visit www.sugarydrinkcampaign.blogspot.com

[NiccoB]

10:50 AM on 02/16/2012

Has anyone ever called the big food companies 1-800 numbers to complain about why on earth they had to put sugar in such products as "Home-made style" soup, all the packaged breads, pasta sauces etc? I have - and I really let them know that I wouldn't be buying any more of their products again. We should all do this, it's ridiculous!

[JFK1]

12:23 PM on 02/13/2012

The first step is to remove non-nutritious lunches from schools. They should never have allowed sodas and fruit-flavored sugar drinks in schools. This would be the start of generational change.

Money talks. Rich people don't want to be taxed for public schools. Big business uses its money to push sugar drinks and fast-food into schools, so they can gain customers for their lifestyle for life.

I used to buy fruit juices in the "glass juice" isle at the grocery store. But those are just sweetened drinks too. When I was a kid, cranberry juice was really tart. You can't get that now; it's been sweetened, largely with grape juice. At work I drink water, because soda weighs me down and makes me tired. Giving up sugar at home is going to be really difficult because it tastes so good.

[barrashee]

05:05 PM on 02/10/2012

Why must the solution to every problem involve more taxation or regulation by the government? Let the public at large read this article and make theri own voluntary lifestyle changes. Business will change to meet consumer preferences, it always has.

[egdot]

02:33 PM on 02/11/2012

Do you think the food companies are going to reduce sugar? Are we making our own lifestyle choices when currently business has no incentive to change its practices? They make our lifestyle choices for us by relentless advertising and then tell us we're making the choice. The tobacco industry knew for years how toxic cigarettes were. Did they ever release the information to the public until they were forced to do it? To this day they try to deny it. Business, in this case, did not change to meet consumer preferences.

The public at large or the large public needs to be properly and repeatedly informed - something business tends not to do unless forced. You aren't making choices unless you are informed properly. At the very least the food industry should be barred from claiming their sugar-laden products are health-promoting. How about government health warnings? Would you settle for that?

[barrashee]

06:56 PM on 02/15/2012

Yes I would. Now consider the organic food market--a business that grew to fill a desire for more wholesome foods. Its possible for such growth to occur around sweets as well. There are more products sweetened with xylitol, and you cn buy xlitol in bulk as well. Xylitol is a naturally occuring sugar which neither we nor the bacteria that cause cavities can metabolize.

[themantimes8]

10:50 AM on 02/09/2012

I believe that it would not be necessary to regulate sugar levels if most people knew of the dangers associated with over-eating sugar. Many people just eat whatever they want and drink soda all day, but what they don't realize is that this type of diet is killing them. The lack of exercise is also a huge problem that when accompanied by a poor diet, leads to serious, life-threatening (or life-shortening) problems. Everyone needs to know that our diets are extremely important to our health. It really isn't that hard to stop eating McDonalds and stop drinking soda. If the demand for the sugary foods and drinks goes down, suppliers will stop making them-Simple economics! It is OUR fault that there is so much sugar in everything because we keep buying and buying those products. Complaining about sugary drinks and buying them anyways just perpetuates the problem. Stop buying sugary drinks and it becomes one less thing to worry about.

[thewirah]

12:49 PM on 02/08/2012

One of the most interesting argument of the original article is that up to 40% of normal-weight people develop the diseases that constitute the metabolic syndrome: diabetes, hypertension, lipid problems, cardiovascular disease andnon-alcoholic fatty liver disease.

Obesity is only a possible symptom, which not everyone experience. People who are skinny despite all those lattes and cokes aren't necessarily healthier than their overweighted counterparts. Fructose is a silent killer.

[egdot]

02:35 PM on 02/11/2012

One wonders whether the epidemic of Alzheimer's Disease might be related too...

[scottykamehamehameha]

03:36 PM on 02/11/2012

One wonders whether you are properly educated to make such a link. The idea that the average American is sufficiently educated to make any determination regarding this issue is laughable. This is exactly the same as the over-vigilance or parents in the 1970s and it's scare mongering. Alchohol and lack of exercise are still much more significant factors in public health.

[hector74elp]

07:08 PM on 02/06/2012

i think the problem is that when people compare the 2 things is that people only really think about the buzzed feeling after having one to many. Nobody really knows about how sugar affects the body. This is a good video that tells how sugar and alcohol are alike.
http://www.youtube.com/watch?v=dBnniua6-oM

[MEEU]

01:51 PM on 02/06/2012

Would you board an airplane when inspections show it has a major defect and is likely to crash? Not likely! A diverse group of otherwise unrelated corporations I call Big Fructose all know fructose in foods means folks eat more of everything and develop more diseases to treat and prevent. To say this is nonsense is like believing Big Tobacco was unaware that their products were addicting and caused suffering and early death.

For those of us who want to limit regulation I suggest we Insist governments put grams of fructose and fructose warnings on food labels. We can also voluntarily limit fructose to 10grams per day. This is amount in one medium apple. We can stop buying food and drink that contain fructose until stores make fructose free options available and tasty.

[morgantee]

12:38 PM on 02/06/2012

When will we learn- it's not what we are eating-- it's the lack of exercise. We are such a sedentary society. We drive everywhere. Parents in my neighborhood drive their kids to the bus stop- at the end of their street! We sit in front of computers or Ipads or cell phones texting. We work 14 hour days. We need to move-- and I don't mean become gym rats. But we need to walk more and play more. Our kids come home after being at school which has eliminated physical education from the curriculum, they sit in front or TVs or video consoles for hours, we eat fast food that overworked Mom brought home cause she's too tired to cook. We eat later because Mom worked late and so we all did not eat dinner til 9pm and then we watched more TV and went to bed. We feel sluggish in the morning cause we are eating such unhealthy food. We grab a bowl of cereal-which is sugar-laden- and we get driven to school. I mean how much walking are we doing from the driveway to the couch to the bed? We just need to move more as our first step and watch portion control. I don't believe it's just what you are eating. If you exercise more than you intake- you will lose weight no matter what you are eating.

[thewirah]

12:40 PM on 02/08/2012

Poison is poison. Excercising will only alleviate so much the damage done to your body done by drinking too much, smoking too much or eating fat and sugars.

[scottykamehamehameha]

03:42 PM on 02/11/2012

Completely untrue. Changing your metabolic rate and calorie consumption makes all the difference on what remains in your body. You are making an astonishing oversimplification based on ignorance.

[Mickey1]

10:12 AM on 02/06/2012

the beta is not displaying my comments?

[Mickey1]

10:14 AM on 02/06/2012

?

[Raven1970]

10:32 AM on 02/05/2012

Rather than regulating sugar itself, it's time to take a real hard approach to the advertising and marketing of high sugar products...zero calories does not mean it is a good health choice...a bowl of fruit loops is NOT a part of a healthy breakfast (I do love how they have it presented with a glass of juice, whole wheat toast and fruit, that is the healthy breakfast..I guess if you put the cereal near it, it can be part of a healthy breakfast) It's marketing trickery and seduction that makes these foods so appealing...then the added sugars, salts and artificial flavorings make them downright addicting.

In addition, processed foods are so much less expensive than real foods, so families are often forced into making poor choices based on quantity rather than quality.

We do not have to regulate sugar, we need to do some corporate smack downs....

[Letfreedomring12]

08:57 AM on 02/05/2012

God, no. I personally don't want the government in my house telling me what to eat. Where does it end? I know sugar is a drug, so I keep it and processed foods out of my kitchen. I don't need Big Brother watching out for me. Thanks just the same. Let people figure it out for themselves and make their own choices, for better or for worse. In a free country, we should be free to choose what we eat, for God's sake.

[UCBAlum]

12:00 PM on 02/05/2012

Since when did "regulation" equate to a ban on choice? We regulate cigarettes and alcohol, and that leads to more information with which consumers can make choices, not less.

If you don't eat sugar then it would not affect you at all, so what's your issue?

[barrashee]

09:26 PM on 02/10/2012

On eissue with govt regulation is that it costs more money. All those bureacrats must be fed! Another issue is the tendency to develop turf and turf wars. The EPA recently began to demoand dairy farmers institute the same safeguards for oil spills as petroleum companies must do, because milk has oils in it. Congress actually had to rein in the bureacrats. SO govt empowermnet is deangerous and expensive and usually becomes ludicrous

[Letfreedomring12]

11:41 AM on 02/19/2012

The point isn't whether I eat sugar or not. The point is that we are becoming a country burdened by increasing governmental regulation (and more taxation to pay for the ever-expanding, more intrusive role of government in our lives.) Today it's sugar. What is it tomorrow?

Regulation IS a ban when the government taxes a product to the point that only the rich can readily afford it - and that where these things end up.

The government should step in only if food manufacturers are holding a gun to your head to use their products, but that's not the case. No one is forcing you to purchase processed foods loaded with sugar. You have 100% freedom of choice about what you buy and what you put in your mouth.

If you don't like unhealthy food, don't buy it. Read labels, buy produce from the local farmer's market, cook at home.

We are bombarded with information about healthy eating. 'Strive for five' etc. It's not for lack of information that people eat crap. It's a matter of priorities. The average American watches 34 hours of TV a week. You're telling me that we can't do better as individuals in our eating habits without government intervention? I don't buy it.

[thewirah]

12:42 PM on 02/08/2012

Everybody knows that there should be safeguards. No one is preventing your from drinking or smoking.

[scottykamehamehameha]

03:46 PM on 02/11/2012

They limit where individuals can smoke based on completely false research on second-hand smoke. The significance and link in causation in those studies is laughable. The extra taxation on the drinking and smoking lifestyle validates abstinence and invalidates people who want to consume these things, and enforces this ideology economically. Individuals who smoke pay more than ten times the cost of a pack of cigarettes from a decade ago -- Just because someone has decided on their behalf that they should not smoke. Individuals should be in charge of their own health.

[boo tatro]

12:42 AM on 02/05/2012

This outlawing, overpricing, control needs to STOP. Are we going to learn things are bad if we keep controlling everything. We are adults. Let some people die if they must. But lumping all of us into one slot, its not fair for the ones who do things right. It's like punishing the good kid's as well as the mischievous one's. You can not over regulate society. It just doesn't work, Just ask any drug dealer.

[babybecks]

11:09 PM on 02/04/2012

I was looking at the yogurt for kids in the store the other day, some had 20 and 30 grams of sugar, more than the grownup versions. Why are we feeding things like that to our children? Tremendous amounts of sugar are in absolutely everything. So unnecessary.

[Kazzim Zongo]

11:23 PM on 02/04/2012

Why are we buying them?

[babybecks]

11:30 PM on 02/04/2012

I'd be willing to bet most parents don't read the labels. They see something intentionally marketed for children, and don't assume that it's harmful for them.

[bighairypussy]

11:36 AM on 02/06/2012

have been reading labels for years now, remember even calling yogurt maker and asking when sugar free versions will be out - bleh "they will not be" was told.... so there you have it