Monday, 13 February 2012

Sugar: it's time to get real and regulate

The consumption of fructose and sucrose is on the increase – and so are preventable diseases such as Type 2 diabetes

Last week, a trio of American scientists led by Robert Lustig, professor of clinical paediatrics at the University of California, published an article in the journal Nature, outlining the toxic effects that sugar has on humans and arguing for governmental controls on its sale and distribution. While the authors come short of labelling sugar a "poison" outright, in a 2007 interview with ABC Radio about excess sugar consumption, Lustig said: "We're being poisoned to death. That's a very strong statement, but I think we can back it up with very clear scientific evidence."

That evidence has been growing – particularly in the western world, where consumption of sugar is increasing rapidly. Globally, sugar consumption has tripled in the past 50 years. But, it turns out, the greatest threat to human health is one type of sugar in particular: fructose.

In the US, per-capita consumption of fructose, a common food additive there – mainly in the form of high-fructose corn syrup – has increased more than 100-fold since 1970. Although fructose is not a common added sweetener in the UK and other countries, sucrose is; sucrose contains 50% fructose. Lustig and his co-authors note that last year, the United Nations announced that non-communicable diseases (NCDs) had, for the first time, overtaken infectious diseases in terms of the global health burden. Non-communicable diseases now account for 63% of all deaths, and that total is expected to increase by a further 17% over the next decade.

The scientists cite growing evidence that our increasing consumption of sugar is partly responsible for the growth of NCDs: diseases such as cardiovascular disease, cancer, diabetes and the suite of symptoms known as metabolic syndrome. And they argue that, as for substances known to cause NCDs such as tobacco and alcohol, sales and distribution of sugar should be controlled, and products with added sugar should be taxed.

I used to be a sugar addict. And yes, for those who haven't found out first-hand, sugar is addictive; perhaps not to the same degree as alcohol and tobacco, but a recent study has shown that sugary foods, or even just the expectation of eating sweets, can trick the brain into wanting more. When I decided to cut my sugar consumption 12 or so years ago, I had no idea of the serious health concerns that excess sugar consumption brings. I only wanted to avoid the so-called "empty calories" that sugar provides. I had noticed that eating cookies and desserts was making me feel lethargic.
Sugar, and in particular fructose, affects metabolism. Unlike glucose, fructose can only be metabolised in the liver. Some of its effects on the human body include increasing levels of uric acid, which raise blood pressure; increased fat deposition in the liver; and interference with the insulin receptor in the liver. This inhibits ability of the brain to detect the hormone leptin, which regulates appetite. So beyond the empty calories that fructose provides, eating it makes you want to eat more.

When I started reducing my sugar intake, I had no intention of cutting it out completely. Reducing my consumption was a gradual process, over many years. Sugar had been used as a reward when I was a child, and sweets were still a comfort food for me. But I found that the less of it I ate, the less I craved it. Today, I barely eat sweetened foods at all. If I were to eat what to most North Americans or Europeans is an "average" dessert serving, I would feel sick. Avoiding sugar is no longer an exercise in willpower; I have developed a revulsion for it. I feel that I have brought my body back to its original state. Sugar, in anything other than small quantities, feels like a poison to me.

Illnesses related to dietary choices do not affect only the individuals who become sick; they affect us all, as a society. The US alone spends $150bn on healthcare resources for illness related to metabolic syndrome. Of course, I would like to think that governmental regulation of a food-item such as sugar is not necessary. I do place value on an individual's right to choose, and on personal responsibility. But in the case of sugar, it's time to get real. The incidence of preventable diseases such as Type 2 diabetes is increasing and many health authorities have expressed concern that our current youth may be the first generation that does not live as long as their parents.

Most of us have known for some time that excess sugar is not good for us, but education and knowledge are clearly not enough. Regulation is required. This is no longer an issue of personal responsibility, but one of public expenditure and public health.

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