Saving Us from Sweets: This Is Science and Government on Sugar.

by Kenneth W. Krause.

Kenneth W. Krause is a contributing editor and “Science Watch” columnist for the Skeptical Inquirer.  Formerly a contributing editor and books columnist for the Humanist, Kenneth contributes regularly to Skeptic as well.  He may be contacted at krausekc@msn.com.

I’ve carried an intense personal grudge against “sugar” for decades.  No, not the mostly benign, unrefined types packed into blueberries, green beans, and pumpernickels, for example.  And, no, not only the sickly-sweet stuff shamelessly dumped into sodas, pastries, and swirling coffee froths either.  I truly despise every pale-ish, pure and innocent looking slice of bread, wedge of potato, and grain of rice, and, I promise you, no pasta noodle, cracker, or corn flake will ever again bamboozle its way into my ever-shriveling food pantry.

At emotionally critical moments, my well-intentioned mother told me I was “husky” or “big-boned,” which, by the way, is never true if it needs to be said.  I was just plain F-A-T—obese, actually, like more than a third of Americans today—until my junior year of high school.  At that fateful point, I got fed up and decided to take matters into my own ignorant yet determined hands.  Thanks to vigorous exercise and a dramatically reformed diet, I dropped seventy pounds in about three months.  From then forward, my world just got bigger and brighter.

Even now, at forty-seven, I can relish every exhilaration my aging body will tolerate.  In fact, I’ve recently given up weight lifting and jogging for power lifting, plyometrics, and high-intensity intervals.  Last month, I took up mountain biking (the initial wounds should heal well before publication) because road cycling just wasn’t exciting enough anymore.

I’m not bragging.  Truth be told, I’m not particularly good at any of it.  The point, rather, is that I love it all, and that I should have enjoyed an even richer physical life as a kid.  In some tragic measure, I squandered the most dynamic years of my life guzzling and gobbling the same general strain of refuse that farmers use every day to fatten their pathetic cattle for slaughter.  Yes, I’m a little bitter about sugar.

And I’m clearly not alone.  “Clean-eating” advocates now dominate the nutrition world, and most of us agree generally with food guru Michael Pollen that we should eat less, mostly plants.  Nevertheless, others in our ranks have lately embraced a more militant and less scientifically defensible approach to the problem.

Take, for example, Robert Lustig, Laura Schmidt, and Claire Brindis, three public health experts from the University of California, San Francisco.  In a recent issue of Nature, they compared the “deadly effect” of added sugars (high-fructose corn syrup and sucrose) to that of alcohol (Lustig, et. al. 2012).  When consumed to excess, they observe, both substances cause a host of dreadful maladies including hypertension, myocardial infarction, dyslipidaemia, pancreatitis, obesity, malnutrition, hepatic dysfunction, and habituation (if not addiction).(1)

Far from mere “empty calories,” they add, sugar is potentially “toxic.”  It alters metabolisms, raises blood pressures, causes hormonal chaos, and damages our livers.  Like both tobacco and alcohol (a distillation of sugar), it affects our brains, encouraging us to increase consumption.  Indeed, they say, worldwide sugar consumption has tripled in the last 50 years.

Thus, Lustig et.al. infer that sugar is partly responsible for 35 million deaths every year from chronic, non-communicable diseases, which, according to the United Nations, now pose a greater health risk worldwide than their infectious counterparts.  The authors point out as well that Americans waste $65 billion in lost productivity and $150 billion on health-care related resources annually vis-à-vis illnesses linked to sugar-induced metabolic syndrome.

At the risk of piling on, I should emphasize that 17 percent of U.S. children are now obese too, and that the average American consumes more than 40 pounds of high-fructose corn syrup per year.  Recent investigations suggest that sugar might also impair our cognition.  In a new rat study from the University of California, Los Angeles, for example, physiologist Fernando Gomez-Pinilla concludes that diets consistently high in fructose can slow brain functions and weaken memory and learning (Agrawal and Gomez-Pinilla 2012).

All of which reinforces my already firm personal resolve.  But apparently many accomplished scientists lack not only confidence in our abilities as individuals to educate or control ourselves, but also respect for our rights to disagree or to make informed but less than perfectly rational decisions regarding our private consumption habits.  As such, they urge Americans especially to support restrictions on their own liberty in the form of government-imposed regulation of sugar.

To support their cause, Lustig et. al. rely on four criteria, “now largely accepted by the public health community,” originally offered by social psychologist Thomas Babor in 2003 to justify the regulation of alcohol.  The target substance must be toxic and unavoidable (or pervasive), and it must have a negative impact on society and potential for abuse.  Sugar satisfies each requirement, they contend, and is thus analogous to alcohol in terms of demanding bureaucratic imposition.

In a letter to me, Gomez-Pinilla echoed their concerns.  Diabetes and obesity, he specified, come with greatly increased risks of several neurological and psychiatric disorders.  In light of both the human and economic costs, he opined broadly, “it is in the general public concern to regulate high sugary products as well as other unhealthy aspects of diet and lifestyle.”

Unsurprisingly, the Nature paper inspired a flurry of defiant correspondences.  Observers close to the sugar industry quickly took issue with both the researchers’ facts and their logic.  Richard Cottrell from the World Sugar Research Organisation in London first disputed the San Franciscans’ calculation of worldwide sugar consumption (Cottrell 2012).  Because global population has more than doubled since 1960, he corrected, intake has increased only by 60 and not 300 percent.  Moreover, he added, consumption in the U.S., U.K., and Canada has risen only marginally as a proportion of total food-energy intake.

Judging metabolic syndrome a “controversial concept” in itself, Cottrell then cited analyses from the UN, U.S., and Europe finding no evidence of typical sugar consumption’s contribution to any non-dental disease.  On the other hand, he chided, “Overconsumption of anything is harmful, including water and air.”

Ron Boswell, a senator for Queensland, Australia, noted that while the overweight population in his country has doubled and the incidence of diabetes has tripled since 1980, sugar consumption has actually dropped 23 percent during the same period (Boswell 2012).  To describe sugar as “toxic,” he continued, “is extreme, as is its ludicrous comparison with alcohol.”  The senator then scolded Lustig et. al. for risking “damage to the livelihoods of thousands of people working in the sugar industry worldwide.”

Other writers were no less reproachful.  Christiani Jeyakumar Henry, a nutrition researcher in Singapore, criticized the Nature piece for its exclusive emphasis on sugar (Henry 2012).  Several foods with high glycemic indices, he noted, including wheat, rice, and potatoes also contribute to both obesity and diabetes.  Finally, writing from the University of Vermont, Burlington, Saleem Ali criticized the San Franciscans’ “misleading” comparison of sugar to alcohol and tobacco, the former of which causes neither behavioral intoxication nor second-hand contamination (Ali 2012).

But Dr. David Katz, renowned nutritionist and founding director of the Yale University Prevention Research Center, has long contested Lustig’s claims.  Last spring, for example, Katz characterized the researcher’s dualistic, good vs. evil attacks on sugar as fanatical “humbug” (Katz 2011).  “It is the overall quality and quantity of our diet that matters,” he reasoned, “not just one villainous or virtuous nutrient de jour.”

Refreshingly, Katz reassessed the subject from a broader, more reliable perspective based on evolutionary science.  “We like sweet,” he appreciated, “because mammals who like sweet are more apt to survive than mammals who don’t.  Period.”  Why should it shock and abhor so many of us that sugar is addictive?  The real surprise, Katz answered, is not that high-energy food is habit-forming, “but rather that anything else is.”

Katz’s subsequent response to the Nature article, however, sends a frustratingly abstruse and well-mixed message.  On the one hand, he recognizes that “Regulating nutrients, per se, is a slippery slope” (Katz 2012).  Good intentions, he wisely if somewhat vaguely counsels, “could bog us down in conflict that forestalls all progress, distort the relative importance of just one nutrient relative to overall nutrition,” and lead us to “unintended consequences.

On the other hand, Katz expressly defends some of Lustig et. al.’s proposed governmental intrusions.  Most reasonably, he favors restrictions on the sale of sugary products to kids where their attendance is officially compelled.  “There is no reason,” he argues, “why schools should be propagating the consumption of solid or liquid candy by students.”  Many locales have already seen fit to install such policies.

Far less noble, however, is the good doctor’s support for punitive taxes on sugary drinks.  “There is no inalienable right to afford soda in Constitution,” he observes.(2)  Those of lesser means, Katz resolves, “should perhaps consider that they can’t afford to squander such limited funds on the empty calories of soda.”  Indeed they should, but Katz never explains how people can make decisions already made on their behalf.

But—in the name of science, most regrettably—Lustig et. al. advocate considerably more intrusive schemes decorously styled “gentle, supply-side” controls.   Unsatisfied with a soda tax, they favor a similar penalty on “processed foods that contain any form of added sugars.”  That means ketchup, salsa, jam, deli meat, frozen fruit, many breads, and chocolate milk (now highly rated as a recovery drink following intense exercise).  Ideally, the trio adds, such tariffs would be accompanied by an outright “ban” on television advertisements.

The San Franciscans would like to “limit availability” as well, by “reducing the hours that retailers are open, controlling the location and density of retail markets and limiting who can legally purchase the products.”  Alluding to a cadre of parents in South Philadelphia who recently blocked children from entering nearby convenience stores for snacks, Lustig et. al. inquired, “Why couldn’t a public-health directive do the same?”

In late May of this year, New York City Mayor Michael Bloomberg announced the first plan in U.S. history to outlaw the sale of large sugary drinks—anything over 16 fluid ounces—in all restaurants, movie theaters, sports arenas, and even from street carts.  If approved by the Bloomberg-appointed Board of Health, the ban could take effect next March.

Sugar can be bad; most of us get that.  But even the most impassioned personal grudge against potentially harmful food is just that—personal.  Science, like government, is valued beyond calculation insofar as it expands personal choice.  But the appropriate boundaries of science are almost always exceeded when it attempts to join with government to first judge the masses incompetent and then restrict their personal choices.

I grow particularly nervous when even the most distinguished researchers transcend their callings to campaign for product taxes and bans, or, most egregiously, to vaguely advocate for the regulation of “unhealthy aspects of diet and lifestyle.”  Science’s time-tested authority springs vibrantly from its practitioners’ exacting and impartial roles as explorers, skeptics, and even teachers.  But never has it spawned from the deluded cravings of some to act as our parents or priests.

Notes:

(1)  The authors dispute the common assertion that these diseases are caused by obesity.  Rather, they argue, obesity is merely “a marker for metabolic dysfunction, which is even more prevalent.”  In support, they cite statistics showing that 20% of obese people have normal metabolism and that 40% of normal-weight people develop metabolic syndrome.

(2)  Neither “inalienable” nor “unalienable” rights are listed in the Constitution, of course.  But three of the latter—life, liberty, and the pursuit of happiness—are enshrined in the Declaration of Independence.  Katz and others might wish to reexamine their historical and philosophical significance.

References:

Agrawal, R., and Gomez-Pinilla, F. 2012. ‘Metabolic syndrome’ in the brain: deficiency in omega-3 fatty acid exacerbates dysfunctions in insulin receptor signaling and cognition. The Journal of Physiology 590.10: 2485-2499.

Ali, S.A. 2012. Sugar: other ‘toxic’ factors play a part. Nature 482: 471.

Boswell, R. 2012. Sugar: there’s more to the obesity crises. Nature 482: 470.

Cottrell, R.C. 2012. Sugar: an excess of anything can harm. Nature 483: 158.

Henry, C.J. 2012 Sugar: a problem of developed countries. Nature 482: 471.

Katz, D. 2011. Sugar isn’t evil: a rebuttal.  http://www.huffingtonpost.com/david-katz-md/sugar-health-evil-toxic_b_850032.html

Katz, D. 2012. Sugar on a slippery slope.  http://www.huffingtonpost.com/david-katz-md/sugar-regulation_b_1255695.html

Lustig, R.H., Schmidt, L.A., and Brindis, C.D. 2012. Public health: the toxic truth about sugar. Nature 482: 27-29.

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