by Micaela Young
Blaming sugar for the obesity epidemic is tempting, but making it a target of public and policy concern may create unwarranted fear and an increased demand for sugar-free and sugar substitute products, steering us down an all too familiar—and perhaps even unhealthier—road.
It wasn’t too long ago that industry grabbed onto another contentious nutrition target during the anti-fat movement, profiting largely from a new host of fat-free and reduced-fat products, many of them packed with refined carbohydrates and sugar. In the 1980s, medical and nutrition science had not advanced enough to know that the link between total dietary fat and heart disease was far from clear. The first edition of the Dietary Guidelines for Americans in 1980 demonized fat and, as a consequence, sparked a wave of food industry innovation that grew to replace unwanted fats with refined carbohydrates and sugar. A probable catalyst for the U.S. obesity epidemic, this industry reformulation is a potential promoter of heart disease and diabetes, as suggested by several well-designed studies examining the consequences of a low-fat, highly-refined carbohydrate diet published over the last six years from top-tier journals: including the American Journal of Clinical Nutrition, Annals of Internal Medicine and Current Atherosclerosis Reports.
Earlier on, however, nutrition scientists had an inkling that not all dietary fat was created equal. Specifically, replacing trans fats and saturated fats with monounsatured and polyunsatured fats was more effective at reducing the risk of heart disease than reducing overall fat intake, as revealed in a 1997 study published in the New England Journal of Medicine. While there will always be debate and uncertainty, the health benefits of consuming certain dietary fats have gained a positive view in the scientific community, as reflected in the new 2015 Dietary Guidelines.
While this shift in thinking may be viewed as a gross misconception by the science community—having such a negative impact on public health—what is important to remember is that science is a dynamic, ever-revolving door. New evidence can change scientific thinking rapidly, calling important “facts” into question, but public opinion and consumer purchasing habits are much harder to change.
Today, history may be repeating itself, with a plethora of anti-sugar campaigns and policy movements following the flood of new research linking sugar consumption to obesity, diabetes prevalence, and heart disease. It turns out that sugar is a tricky beast to target, so public health advocates have gone after sugar-sweetened beverages. This is not a fool’s errand, however, because drinking your sugar seems to pile on the pounds, according to a randomized trial from the New England Journal of Medicine and a meta-analysis from the American Journal of Clinical Nutrition. In addition, added sugars are now thought to contribute to chronic disease risk and increased mortality, according to a 2015 study co-authored by Dr. Dariush Mozaffarian, dean of the Friedman School of Nutrition Science and Policy. Researchers estimated that sugar-sweetened beverages were responsible for 6,450 deaths from cancer, 45,000 deaths from cardiovascular disease, and 133,000 deaths from diabetes world-wide.
The public has caught on to this buzz around the negative effects of sugar consumption, and following suit are the usual suspects: the food industry (the wide-eyed consumer will notice new sugar-free and granulated sugar substitutes creeping onto grocery store shelves) and nutrition propaganda (anyone care to join me on Food Babe’s 7-day sugar detox?).
Policy makers have even jumped on the anti-sugar bandwagon, including former Mayor of New York City Michael Bloomberg, who in 2012 fought to ban the sale of sweetened drinks of more than 16 ounces. While Bloomberg’s proposal ended in a court decision denying his ban from going into effect, these types of efforts still continue.
Even though the concerns over added sugar consumption are warranted given current scientific consensus, the ambiguity around what these types of prohibitions on added sugars will do come from many factions: anti-hunger groups, scientists, and the soda-guzzling consumer who fears for his rights. One scientist against the banning and taxing of foods with high amounts of added sugars is Brian Wansink, the director of the Cornell University Food and Brand Lab, because he fears the unintended consequences. His reasons are just; in 2006, his lab conducted a study that linked low-fat labeled foods to misconceptions about the healthfulness of the products. On average, participants underestimated the calories in “low-fat” M&Ms and other foods by almost 50%, and, surprisingly, overweight individuals ate 60 more calories than normal-weight participants when presented with low-fat labeled foods.
In 2014, Wansink’s lab conducted a similar study on the implications of a soda tax after noticing more sugar-free foods on the market, and an increased effort to ban or tax sugar-sweetened beverages in certain locales. The results concluded consumers often made unhealthy substitutions for sodas. The main replacement? Beer and other high-calorie drinks. Not exactly the swap public health advocates were hoping for.
It is evident that something must be done to ease this public health concern, but the solution that will yield its intended results has not yet become apparent. The food industry uses current nutrition science to bring patchwork, processed foods to life, which can work monstrously against public health efforts. The important thing to remember is that, as stated in the 2015 Dietary Guidelines key recommendations, a healthy eating pattern limits added sugars (sorry, palm sugar) to 10% of calories per day—not including sugars from whole foods and fruits.
“It is clear that many Americans are consuming far too much sugar,” said Jeanne Goldberg, PhD, professor of nutrition and director of the graduate program in Nutrition Communication at the Friedman School. “But the best way to figure out if you are one of these people is to take a moment to figure out just how much you are getting, from your first bowl of frosted covered cereal in the morning to your last cup of tea. If this is over 12 teaspoons (about 50 grams) of added sugar—including the sugar in your frosted cupcake, not the sugar in your sugar snap peas—then you may need to cut back.”
Therefore, before we grab our torches and pitchforks and march toward Sugar’s house, let’s take a step back and think about the long-term implications of our well-intended actions. We would not want to steer the public towards an unhealthier eating pattern that, for example, includes more processed “sugar-free” foods with even more refined carbohydrates…
Micaela Young, CPT is a first year nutrition communication and behavior change student focusing in Agriculture, Food and Environment. She would trade you frosted cupcakes and breakfast cereal for chips and salsa any day.