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Sweet Nothings

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When I first began my work on food safety and nutrition in 1970, people knew that tasty, familiar white sugar was just "junk" and "empty calories." Sugar was derided because it was devoid of vitamins and minerals and it promoted tooth decay.

But recent studies have begun to demonstrate that the large amounts of added (or refined) sugars -- including cane and beet sugar, high-fructose corn syrup, plain corn syrup, and dextrose -- in our diets are harming much more than our teeth.

Although levels have declined in the past decade, we still consume an awful lot of sugar. According to estimates by the U.S. Department of Agriculture, the average person takes in almost 400 calories' worth of refined sugars a day, and many people consume far more. In fact, more than 35 million people get more than one-fourth of their calories from refined sugars [1]. Almost half of that sugar comes from liquid candy: soft drinks, sports drinks, energy drinks, fruit drinks, and the like.

Studies that track thousands of people for years find that those who consume more sugary drinks have a higher risk of weight gain, diabetes [2], heart disease [3], and gout [4]. When scientists give people sugary drinks, they put on more weight than people who get calorie-free drinks. And when researchers give people hefty amounts of fructose, which constitutes about half of sugar and high-fructose corn syrup, they see a rise in deep belly fat and in blood levels of triglycerides, glucose, insulin, and LDL ("bad") cholesterol -- all precursors of heart disease. Moreover, the more sugar (from foods and beverages) that people consume, the fewer nutrients they get.

The American Heart Association recommends that women consume no more than six teaspoons of added sugars a day and that men consume no more than nine. To put that into context, a can of Coke contains 9 teaspoons of added sugars, and a 6-ounce flavored yogurt has about five teaspoons.

But advice from health experts can do only so much in a society where cheap sugary drinks and foods are sold at every fast-food outlet, convenience store, coffee shop, gas station, drugstore, and supermarket.

Luckily, companies are developing safer, better-tasting, high-potency sweeteners made from natural sources like stevia leaves. Others are working on "sweetness enhancers" that make one teaspoon of sugar taste like two.

The time has come for the Food and Drug Administration to reevaluate the safety of sugary drinks. That's what the Center for Science in the Public Interest, several dozen nutrition experts, seven local health departments, and 15 nonprofit organizations have asked the FDA to do.

I think -- and some soft-drink industry officials agree -- that the amount of sugar in beverages could be cut by 75 percent or more and they'd still taste great. I'll drink to that!


1. Marriott BP, Olsho L, Hadden L, et al. Intake of added sugars and selected nutrients in the United States, National Health and Nutrition Examination Survey (NHANES), 2003-2006. Crit Rev Food Sci Nutr. 2010;50:228-58. (This study was funded by the industry-sponsored International Life Sciences Institute.)

2. Hu FB, Malik VS. Sugar-sweetened beverages and risk of obesity and type 2 diabetes: epidemiologic evidence. Physiol Behav. 2010(Apr 26);100(1):47-54.

Malik VS, Schulze MB, Hu FB. Intake of sugar-sweetened beverages and weight gain: a systematic review. Am J Clin Nutr. 2006;84:274-88.

3. de Koning L, Malik VS, Kellogg MD, et al. Sweetened beverage consumption, incident coronary heart disease, and biomarkers of risk in men. Circulation. 2012(Apr 10);125(14):1735-41.

Fung TT, Malik V, Rexrode KM, et al. Sweetened beverage consumption and risk of coronary heart disease in women. Am J Clin Nutr. 2009;89:1037-42.

Bernstein AM, de Koning L, Flint AJ, et al. Soda consumption and the risk of stroke in men and women. Am J Clin Nutr. 2012 May;95(5):1190-9.

4. Zhu Y, Pandya BJ, Choi HK. Prevalence of gout and hyperuricemia in the US general population: the National Health and Nutrition Examination Survey 2007-2008. Arthritis Rheum. 2011(Oct);63(10):3136-41.

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