Is sugar as bad as alcohol and tobacco?

By Dr. Ananya Mandal, MDFeb 3 2012

According to US health experts, sugar is as damaging and addictive as alcohol or tobacco and should be regulated. The University of California team suggests new policies such as taxes are needed to control soaring consumption of sugar and sweeteners. Prof Robert Lustig argues in the opinion piece called “The Toxic Truth About Sugar” in journal Nature for major shifts in public policy.

Several countries are imposing taxes on unhealthy food; Denmark and Hungary have a tax on saturated fat, while France has approved a tax on soft drinks. Now, researchers in the US are proposing similar policies for added sugar and sweeteners, amid concern about the amount of sugar in the diet. The consumption of sugar has tripled worldwide over the past 50 years, with links to obesity, high blood pressure and diabetes say the authors of the piece, Robert Lustig, Laura Schmidt and Claire Brindis.

In a comment in the journal Nature, Prof Lustig, professor of pediatrics at the University of California, San Francisco, and a leading child obesity expert, says governments need to consider major shifts in policy, such as taxes, limiting sales of sweet food and drinks during school hours, or even stopping children from buying them below a certain age. He said, “It [sugar] meets all the criteria for societal intervention that alcohol and tobacco meet.”

The authors write that sugar is more than just empty calories — that growing evidence links fructose overconsumption with health problems including hypertension and diabetes. “Early studies” link it to cancer and cognitive decline, they write. They also argue that like tobacco and alcohol, “it acts on the brain to encourage subsequent intake.”

While he acknowledges that they face “an uphill political battle against a powerful sugar lobby”, they write in Nature, that “with enough clamor for change, tectonic shifts in policy become possible”. They added, “Take, for instance bans on smoking in public places and the use of designated drivers, not to mention airbags in cars and condom dispensers in public bathrooms. These simple measures - which have all been on the battleground of American politics - are now taken for granted as essential tools for our public health and well-being. It's time to turn our attention to sugar.”

Commenting on the Nature commentary, Dr Peter Scarborough of the British Heart Foundation Health Promotion Research Group at the University of Oxford, said taxing certain food products was something policymakers should consider. But he said taxing only one type of food could have unintended consequences, such as people cutting back on fruit and vegetables to save money for other purchases. He said, “If you only tax one aspect of food like sugar you can have unintended consequences. If you tax fat, salt and sugar, combined with subsidies for fruit and vegetables, you'll get healthier diets.”

Barbara Gallani, director of food safety and science at the UK Food and Drink Federation, said they recognized the worldwide health burden of non-infectious diseases and agreed action was needed. “However, the causes of these diseases are multifactorial and demonizing individual food components does not help consumers to build a realistic approach to their diet,” she explained. “The key to good health is a balanced and varied diet, in the context of a healthy lifestyle that includes plenty of physical activity.”

The Sugar Association, in a response published on its website, says that USDA stats show people are consuming about 425 more calories per day now than 40 years ago, with caloric sweeteners accounting for about 38 of those calories. Meantime, the group contends that consumption of cane and beet sugar has been falling even as obesity rates have been rising.

“We consider it irresponsible when health professionals use their platforms to instill fear by using words like ‘diabetes,’ ‘cancer,’ and even ‘death,’ without so much as one disclaimer about the fact that the incomplete science being referenced is inconclusive at best,” the association says. The obesity problem “originates from the combination of overconsumption of all foods and lack of exercise. To label a single food as the one and only problem misinforms, misleads and confuses consumers, and simply adds to the problem,” the association says.

The National Confectioners Association, meantime, said that the group “supports realistic advice to Americans that accommodate all foods including occasional treats in moderation. There is a place for little pleasures, such as candy, in an overall lifestyle that supports health, wellness and happiness. In fact, helping the public understand how to incorporate little pleasures in their diet may well play the most important role in achieving and sustaining recommended dietary behaviors.”

Comparing sugar to alcohol and tobacco is “simply without scientific merit,” the American Beverage Association said. “There is no evidence that focusing solely on reducing sugar intake would have any meaningful public health impact.”