Scientists at the University of California, San Francisco (UCSF), argue that added sweeteners pose dangers to public health, and the government should regulate sugar in the same way as it regulates alcohol and tobacco. They set out their reasons for viewing sugar as “toxic” in a comment article published in Nature this week.

First author Robert H. Lustig, a a professor of pediatrics, in the division of endocrinology at the UCSF Benioff Children’s Hospital, told the press:

“There are good calories and bad calories, just as there are good fats and bad fats, good amino acids and bad amino acids, good carbohydrates and bad carbohydrates. But sugar is toxic beyond its calories.”

Lustig, who is also director of the Weight Assessment for Teen and Child Health (WATCH) Program at UCSF, and his co-authors Laura Schmidt and Claire Brindis, say in their report that sugar is fuelling a global obesity pandemic and lies behind 35 million deaths worldwide because it contributes to non-communicable diseases like cancer, heart disease and diabetes, which now pose a greater threat worldwide than infectious diseases.

In the US, about 75% of healthcare costs are spent treating these diseases and the disabilities associated with them.

The three authors, who between them represent the fields of endocrinology, sociology and public health, argue that sugar is more than just empty calories that affect health indirectly by making people fat. Worldwide consumption of sugar has tripled in the last 50 years, and is thought to be a main contributor of the global obesity epidemic.

But obesity is just a marker of the toxic effect of too much sugar on publich health, argue the authors, who say the substance has an effect all of its own, particularly at the levels consumed by most Americans, such as changing metabolism, raising blood pressure, altering the signalling of hormones and damaging the liver, something that is not well-known.

These are the same types of damage that alcohol inflicts on the human body, they say, pointing out that alcohol is distilled from sugar.

And it may explain why 40% of people with metabolic syndrome (a stage before diabetes), heart disease, and cancer, are not clinically obese.

Lustig said:

“As long as the public thinks that sugar is just ’empty calories’, we have no chance in solving this.”

Brindis, who is director of UCSF’s Philip R. Lee Institute for Health Policy Studies (IHPS), said changing people’s patterns is not a straightforward problem, it is very complicated.

You can’t just rely on individuals changing, you have to have environmental and community-wide change, just like what has happened with alcohol and tobacco, to increase the chance of success.

Lustig, Brindis and Schmidt argue that for people to change and start eating less sugar, they need to know what scientists are discovering about sugar.

Schmidt, is co-chair of UCSF’s Clinical and Translational Science Institute’s (CTSI) Community Engagement and Health Policy Program, which aims to bring together academic research, health policy, and community practice to improve public health. She said:

“There is an enormous gap between what we know from science and what we practice in reality.”

“In order to move the health needle, this issue needs to be recognized as a fundamental concern at the global level,” said Schmidt, who is also professor of health policy at UCSF’s IHPS.

The authors argue that many of the changes that governments worldwide have made to reduce alcohol and tobacco consumption can be models for reducing sugar consumption. These include special sales taxes, controlling access, and tightening licensing on vending machines and snack bars that market high sugar products in schools, workplaces and other public arenas.

The authors want the balance to change, so that foods that are not heavily laden with sugar are as easy and cheap to obtain as those that are.

Schmidt said:

“We’re not talking prohibition.”

“We’re talking about gentle ways to make sugar consumption slightly less convenient, thereby moving people away from the concentrated dose.”

Funds from the National Institutes of Health helped pay for the study.

Written by Catharine Paddock PhD