Editorial by Robert G. Smith, PhD
A recent article in the prestigious journal Nature explains that sugar, especially fructose, widely available in soft drinks and other processed foods, is responsible for many serious non-communicable diseases, such as heart disease, cancer, diabetes, obesity, and liver failure [1,2]. One of the contributing reasons is that fructose and other high-calorie substances such as alcohol cannot be directly utilized by the body’s tissues so they must be metabolized by the liver, where they generate toxicity and set the body on a path to diabetes . Further, fructose interferes with the body’s sense of satiety, so that an excess of calories tend to be ingested. This overwhelms the liver, which then must convert the overdose of sugar into fat, which harms the liver and can lead to diabetes. Thus sugar such as fructose, when added to processed foods, has been compared to alcohol in its toxic effect. Even non-obese people are susceptible to “metabolic syndrome,” in which fructose induces hypertension, cardiovascular disease, insulin resistance, and damage to biological molecules such as proteins and lipids [1-3].
Soft drinks that contain mainly sugar, such as sodas and filtered fruit juices, don’t have enough nutrients to keep the body healthy and free from disease. They provide calories without essential nutrients that you would find in the whole fruit. These “empty” calories then replace other foods such as whole grains, fruits, and vegetables that are the main source of essential nutrients. But added sugar is not limited to soft drinks. Added fructose, as in high-fructose corn syrup or just plain sugar (sucrose, which is 50% glucose and 50% fructose), is found in a wide variety of processed foods such as breakfast cereal, juices, jellies and jams, candy, baked goods, sauces, desserts, and even ready-made dinners and processed meat. Fructose tastes sweet but does not satisfy hunger as well as more nutritious foods.
The high added fructose content of processed foods is addictive in a similar way to alcohol, especially for young children. This has caused an epidemic of obesity in both children and adults. Further, the metabolism of fructose in the liver is similar to alcohol because it tends to perturb glucose metabolism, generating fat and causing insulin resistance, which leads to inflammation and degeneration of the liver and many other problems . Overall, this dietary pattern caused by overloading our bodies with fructose is a vicious cycle that leads to widespread deficiencies of nutrients such as vitamins and essential minerals, along with damage and inflammation throughout the body. This vicious cycle of sugar addiction, consistent with the “metabolic syndrome,” is in large part responsible for the high death rate from the modern diet.
If the modern diet could be adjusted to satisfy hunger without excess calories and to contain a larger proportion of essential nutrients, the epidemic of disease from added sugar might be averted. When ingested in the form of fruit, fructose is less harmful because it is absorbed slowly by the gut and importantly is accompanied by essential nutrients. Supplements of essential nutrients can help, but only if knowledge about the adequate doses and their benefits is made widely available. Examples are supplements of vitamin A, B vitamins, vitamin C, vitamin E, magnesium, omega -3 and -6 essential fats, which in the proper forms and doses can help prevent dietary deficiencies that cause heart disease, cancer, and diabetes . Other lifestyle choices can help, for example, reducing total calories, increasing ingested fiber, and more exercise . But the benefits of these healthy choices have not been convincing to the modern consumer. Ubiquitous high pressure marketing of soft drinks contributes to the problem.
To correct the problem of sugar overconsumption, it has been suggested that sugar be regulated like alcohol and tobacco . The goal would be to change habits to reduce consumption. Many schools have already banned the sale of sodas, but have replaced them with juices or artificial drinks that contain added sugar. According to this suggestion, the sale of sweetened drinks and processed foods containing added sugar could be limited in school vending machines or elsewhere during school hours. Age limits on the sale of sugary foods in stores might also help. A limit or ban on television commercials advertising products containing added sugar might also be helpful. A tax on sugar, especially high-fructose corn syrup, could be used to fund research into essential nutrients and advertise their benefits. The idea behind such regulation would be to persuade the public, especially children, to consume less sugar and more nutritious foods [1,2]. This could greatly benefit public health.
It has been argued that similar regulation of alcohol is widely accepted because it has kept alcohol consumption under control . For example, in other areas of our lives, changes in what is perceived as acceptable behavior have been successful, like bans on smoking in public places, designated drivers who don’t drink alcohol, and the inclusion of air bags in cars. To some, a similar type of governmental regulation of sugar would seem justified because at the cost of some loss of personal freedom it could improve health and cut short the epidemic of non-infectious disease.
On the other hand, many people see regulation of sugar by taxing foods containing added sugar as abhorrent and draconian. After all, although it is addictive , sugar doesn’t cause the danger of being drunk on the highway, and it doesn’t present an imminent danger to health comparable to smoking. It’s more insidious than that. And sugar has long been part of dietary habits of many cultures. Thus, any governmental regulation of food will have many critics who explain that regulation would be ineffective, and further, we should be able to purchase and eat any food according to our preference.
The underlying issue in this debate is public access to knowledge about nutrition. If the harm that added fructose causes to our health could be widely publicized, along with information about inexpensive and readily available healthy alternatives, this could lead to better health for millions of people. It would cause shoppers to consider other choices, such as vegetable juice or a glass of water, along with unprocessed nutritious foods and vitamin supplements in adequate doses. What is needed is a campaign that provides practical information about diet: what nutrients we need, how to determine the proper doses, and the dangers of a processed-food diet. This could include televised advertisements and health programming, as well as curricula taught at levels from grade school to medical school. It might also include more informative labeling about the nutrient content of food, as well as more healthy and tasty food served at restaurants and dining rooms. Marketplace pressure might then convince food companies to sell more healthy food with a minimum of added sugar and an adequate content of essential nutrients. Orthomolecular medicine, the practice of treating illness by providing sufficient doses of essential nutrients to prevent deficiencies, can help to provide this information [5-8]. We can all become more healthy by forgoing added sugar and other processed foods that lack essential nutrients. And when this is impossible, we can supplement with these essential nutrients to prevent the epidemic of obesity, cardiovascular disease, diabetes, and cancer.
Dr. Robert G. Smith is Research Associate Professor in the Department of Neuroscience, University of Pennsylvania. He is the author of many scientific papers, and an upcoming book, The Vitamin Cure for Eye Diseases.
- Lustig RH, Schmidt LA, Brindis CD (2012) The toxic truth about sugar. Nature 482:27-29.
- Jacobson MF (2005) Liquid candy: how soft drinks are harming Americans’ health. Center for Science in the Public Interest. http://www.cspinet.org/new/pdf/liquid_candy_final_w_new_supplement.pdf.
- Bremer AA, Mietus-Snyder M, Lustig RH. (2012) Toward a Unifying Hypothesis of Metabolic Syndrome. Pediatrics. 129:557-570>/a>
- Lustig RH. (2010) Fructose: metabolic, hedonic, and societal parallels with ethanol. J Am Diet Assoc. 110:1307-1321.
- Brighthope IE (2012) The Vitamin Cure for Diabetes: Prevent and Treat Diabetes Using Nutrition and Vitamin Supplementation. Basic Health Publications. ISBN-13: 978-1591202905.
- Roberts H, Hickey S (2011) The Vitamin Cure for Heart Disease: How to Prevent and Treat Heart Disease Using Nutrition and Vitamin Supplementation. Basic Health Publications. ISBN-13: 978-1591202646.
- Hoffer A, Saul AW (2008) Orthomolecular Medicine For Everyone: Megavitamin Therapeutics for Families and Physicians. Basic Health Publications. ISBN13: 9781591202264.
- Hoffer A, Saul AW, Foster HD (2012) Niacin: The Real Story: Learn about the Wonderful Healing Properties of Niacin. Basic Health Publications ISBN-13: 978-1591202752
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