By Jenn LaVardera
Imagine getting carded the next time you buy a soda. As ludicrous as that might sound, it may become a reality.
According to the United Nations, chronic diseases including heart disease, cancer, and diabetes have become more of a health burden on society than infectious diseases. In September 2011, the UN convened in New York for a High-Level Meeting to discuss prevention and control of the four main non-communicable diseases – cardiovascular disease, cancer, chronic lung disease, and diabetes. Tobacco, alcohol, and diet were targeted as the major risk factors for the development of these diseases. As stated in the Summary Report of the Secretary-General, the best interventions strategies include “tobacco-control measures, including raising taxes and bans on advertising and smoking in public places; raising taxes on alcohol and enforcing bans on alcohol advertising; reducing salt intake; replacing trans-fats in foods with polyunsaturated fats; promoting public awareness about diet and physical activity…”
If tobacco and alcohol can be regulated by the government to protect public health, does it make sense to regulate the other major risk factor – poor diet – in order to prevent disease? Food is essential, unlike tobacco and alcohol, and the regulation process would be different than those of non-essential substances. However, there may in fact be aspects of the Western diet that should be monitored for health purposes according to some experts.
A position paper by leading obesity researchers Robert H. Lustig, Laura A. Schmidt, and Claire D. Brindis from the University of California, San Francisco School of Medicine published in the journal Nature on February 2, 2012 addresses this issue. They contend that sugar consumption is linked to a rise in non-communicable disease; sugar’s effects on the body are similar to those of alcohol; and that regulation could therefore include tax, limiting sales during school hours, and placing age limits on purchase of sugary products.
The team references psychologist Thomas Barbor, who in his 2003 book Alcohol: No Ordinary Commodity presented four criteria that justify the regulation of alcohol. Running through his checklist, it seems that sugar may not be as ordinary as it appears.
1. Unavoidability / Pervasiveness throughout society: Due to the evolution of processed foods, sugar is now in the majority of packaged food products in grocery stores, which limits a consumer’s decision to avoid products with added sugars. Worldwide, people consume an average of 500 calories or more per day from added sugar alone. In the United States the average is well over 600 calories.
2. Toxicity: Sugar not only adds extra calories to the diet but induces all diseases associated with metabolic syndrome, including hypertension and diabetes. It can be reasoned that fructose, a form of sugar widely used in processed foods, has toxic effects on the liver similar to those of alcohol; it raises uric acid and causes damage to lipids, proteins, and DNA through non-enzymatic binding to these molecules.
3. Potential for abuse: Sugar suppresses the hormone ghrelin, which signals hunger to the brain, interferes with leptin, the hormone which produces the feeling of fullness. It also decreases dopamine signaling, which reduces the amount of pleasure experienced from eating and thereby promotes overconsumption.
4. Negative impact on society: The U.S. spends an annual $65 billion in lost productivity and $150 billion on health-care resources for side effects of metabolic syndrome.
This proposition has generated considerable debate. Ron Boswell, senator for Queensland, Australia, responded to Nature claiming “To describe sugar as ‘toxic’ is extreme, as is its ludicrous comparison with alcohol…There is no evidence to suggest that reducing sugar consumption will halt the rise in obesity. The contributing factors are far more complex.” A Canadian group of medical experts subsequently disputed that Lustig et al “are directing attention away from the problem of general overconsumption.”
Commenters to Nature also argued that it is misleading to put sugars in a regulatory league with alcohol and tobacco because sugars do not cause behavioral intoxication nor have second-hand proximity effects. Some suggest that the authors should have recommended individuals to manage a balanced diet with exercise rather than demonize sugar. However, one could also argue that these types of message do exist, and society rarely listens to them.
Though it might seem odd paying an extra tax for a sugary cereal, getting carded to buy a soda, or not being able to purchase a box of doughnuts after a certain hour, sugar and alcohol may not be all too different. Maybe the purchasing of these items should be treated in the same way. Sure, a tax on sugar will likely not solve all of the health problems of the world, but it may be a good start to get people to reach for a bottled water instead of a Coke.
Jenn is a first year Nutrition Communication student with plans to complete her Dietetic Internship post graduation. Her hobbies include running, trying new restaurants, doing cross word puzzles, and attending Dave Matthews Band concerts around the country.