Sugar, the New Tobacco

A generation ago that industry was tobacco and its product was
cigarettes. Today it is the food and beverage industry and its product is
sugar-sugar that is being added to food and drink. Dr Aseem Malhotra, a 37-
year old London, England cardiologist is a leader in the anti-sugar campaign
in Europe. He charges that the food industry has borrowed the corporate
play book of the tobacco industry to fend off regulation. The only
difference, he says, is that while tobacco was avoidable, sugar is currently
almost unavoidable.

Added sugar-not natural sugars that exist in fruits and vegetables-is

everywhere. One of the largest sources is in beverages like soft drinks,
energy drinks and fruit drinks. But a stroll though the supermarket shows
that there is added sugar in bread, yogurt, peanut butter, soup, wine,
sausage-indeed, in nearly any processed food. A single tablespoon of
ketchup can contain a teaspoon of sugar. This invisible sugar comes under
many names. In fact, across the US and Europe, there is the possibility that a
consumer might come across any one or more of at least 83 different names
for added sugar. Helen Bond, a dietitian from the British Dietetic Association
says, Its clever marketing with terms like fructose making people think
they are cutting down on added sugars whereas they might as well be
scattering white sugar over their food.

This added sugar is completely unnecessary, says Dr Malhotra.

Contrary to what the food industry wants you to believe, the body doesnt
require any carbohydrate energy from added sugar. Dr Robert Lustig, a
pediatric endocrinologist at the University of California, San Francisco and a
world leader in the anti-sugar campaign, notes that sugar consumption
worldwide has tripled in the past half-century. But with the population having
doubled in the same time, per capita increase of sugar consumption has
increased 50%. Our food supply now contains so much added sugar that our
metabolic (energy processing) systems just cant handle it, he says. Your
body does different things with different types of calories. Fructose (added
sugar) in quantities eaten today primarily gets stored as fat. Usually, that fat
will go to your belly. And the danger to our health is not just obesity : There
is evidence linking sugar to liver disease, Type 2 diabetes, heart disease and
tooth decay. Nevertheless the food and drink industry continues to promote
sugar with extensive advertising of its sugary products. It also spends large
sums of money opposing clearer labeling of its products, as well as fighting
increased taxation on sugary food and drink.

Its hard to find Europe-wide statistics but in the UK, for example, in
2014 alone the food and drinks industry spent 256 million GBP promoting
unhealthy foods-those high in sugar and/or fat. According to a recent report
of the American Union of Concerned Scientists, nearly $7 billion was spent in
the US on advertising products with added sugars in the same period. Of
this, about $1.7 billion was specifically earmarked to promote such products
to children.

Last year the World Health Organization [WHO] reaffirmed its previous
recommendation that ideally our intake of sugar-except that naturally
occurring in fruits and vegetables-should not exceed ten percent of total
energy intake. The WHO presented strong data linking the consumption of
sugar to rates of obesity and, as Type 2 diabetes is clearly linked to obesity,
then to this disease as well.

In the average diet, ten percent of total energy intake would work out
to about 12 teaspoons of sugar per day. A single 330ml can of soft drink
typically contains around ten teaspoons of added sugar. The average adult
consumption in Western Europe is 20 teaspoons per day-and the average for
children is even higher.

We have solid evidence that keeping intake of free sugars to the ten
percent limit reduces the risk of overweight, obesity and tooth decay, said
Dr Francesco Branca, Director of WHOs Department of Nutrition for Health
and Development in the press release launching the report.

An industry lobby group, The International Council of Beverages

Associations, brushed aside the WHO report, commenting, Regarding
obesity, there is no scientific basis for treating free sugars differently than
intrinsic [non-added] sugars.. Dr Malhotra counters: Thats not true. You
have to take into account the quality of that calorie. Intrinsic sugar occurs in
foods which have other nutritional benefits.

The advertising of sugary foods continues. Overweight and obesity in

children, and the amount of sugary food children continue to eat and drink is
of particular concern to health professionals. One area where experts see
that a difference can be made is in reducing or stopping TV advertising of
sugary foods and drinks around childrens programming.

The Canadian province of Quebec has been a leader in this regard,

restricting such junk food TV advertising to children since 1978. Quebec
now has substantially lower obesity rates than the rest of Canada. Other
countries that have restricted commercials for sugary drinks, cereals and
other junk foods during times when kids watch TV are Norway, Sweden,
Denmark, Mexico and the UK.

However, one analysis found that in the UK food manufacturers have

found other ways to advertise junk food to kids-on the Internet, in product
placements on popular TV shows and through video games.
 An encouraging initiative to limit advertising to children is the EU
Pledge. This began in 2009 as a way for the industry to help meet the
European Unions goal to reduce obesity. Major food and beverage
companies voluntarily agreed to limit advertising sugary junk food to children
under 12. They do not show TV commercials or run Internet ads to this age
group and dont market in primary schools, which marks a significant change
in the way these foods were sold to children. Since the EU Pledge began,
membership has grown to 22 companies, covering more than 80% of food
and beverage advertising in the EU.

Marlene Schwartz, PhD, is the Director of the US-based Rudd Center for
Food Policy & Obesity a non-profit organization dedicated to finding
solutions through research and policy for childhood obesity, poor diet and
weight bias. She says what the EU Pledge is doing is not enough. The EU
Pledge guidelines dont go far enough. We would like to see it extend to
[children] age 14 and under.
Another area of food and drink advertising which Dr Malhotra strongly
opposes is the association of products with athletes, a tactic used by the
tobacco industry just over 50 years ago when both celebrities and athletes
were employed to endorse cigarettes. He questions allowing the Olympics to
be sponsored by Coca-Cola. The companys partnership with the Olympics
that began in 1928 has just been extended to 2020. Coca-Cola associates
their products with sport, suggesting it is okay to consume their drinks as
long as you exercise, he wrote recently in the British Journal of Sports
Medicine.

Let us bust the myth of physical inactivity and obesity. You cannot
outrun a bad diet.
Public health advocates say two approaches that worked to reduce smoking-
consumer education and taxation-are needed to combat over-consumption of
sugar.

A ten percent tax on sugary drinks was introduced in Mexico in January

2014 and drinks sales there fell by 12 percent in the first year. In France, a
tax on sodas introduced in 2012 has resulted in a gradual decline of
consumption. Norway has been active in taxing sugary foods and drinks as
well as education for many years, with good results. In March this year UK
Chancellor George Osborne announced the introduction of a tax on sugary
drinks there, targeting producers and importers of soft drinks and based on
the amount of sugar they contain.

Although there has been some success with taxation, the food and
beverages industries continue to lobby against consumer education-again,
just as the tobacco companies fought government attempts to place warning
messages about the dangers of smoking on cigarette packages.

One proposed approach to inform consumers of the levels of added

sugars in food was to have traffic light labels-red, yellow and green circles
to indicate the healthiness of food and drink products. This scheme,
currently a voluntary and successful program in the UK, was defeated in July
2010 by a majority of MEPs in the European Parliament.

Advocates for labeling spoke out in frustration. Peter Hollins, then chief
executive of the British Heart Foundation, said: The European parliament
should be ashamed of putting the interests of the food lobby ahead of the
health of the people they represent. Mella Frewen, director general of
FoodDrinkEurope (the food and beverage advocacy group, formerly called
The Confederation of Food and Drink Industries of the EEC) said existing
labelling requirements give sufficient information. Europes food and drink
manufacturers are [already] providing clear information on labels, listing
calories and key nutrients, including sugars, which enables consumers to
make informed choices.

The European Consumer Organization (BEUC), which represents some

41 consumer groups in 31 countries, disagrees. Consumers have no idea of
how much sugar they eat, says Ilaria Passarani, head of the Food and Health
Department of the Brussels-based organization.

While the debate about clearer labeling continues in the EU, most
recently the US Food and Drug Administration announced their new template
for nutrition labels. On May 20, the regulatory body added a line on its label
guidelines for added sugar to be placed below a line for total sugar. This
is specifically to allow consumers to distinguish between sugars that occur
naturally in foods and those that do not.

The evidence against sugar and its ill effects on our health continues to
mount as study after study is published. Dr Kimber Stanhope, a nutritional
biologist at the University of California, Davis, completed a five-year
investigation in 2015 linking high fructose corn syrup-a common sweetener
in the United States-to increased risk of heart attack and stroke.

People should realize that there are no risks associated with reducing
sugar intake, says Dr Stanhope, but there are risk factors in continuing to
eat high amounts while waiting for more evidence. Parents should wean their
kids and themselves off daily sugar consumption and consider it a special
occasion food.

New research also indicates that sugar, like tobacco, may be addictive.
Eric Stice, a neuroscientist at the Oregon Research Institute, is using MRI
brain scans on adolescents that show that sugar activates the brain in a
way that is reminiscent of a drug like cocaine. He adds that people build up
a tolerance to sugar much the way smokers and drug users do. That means
the more sugar you eat, the less you feel the reward. The result, you eat
more than ever. Other studies point to sugar being addictive because it
activates the brains pleasure-generating circuitry.

What can you do to reduce your intake of added sugars? Theres

actually an easy way to solve this problem in the home; its called real food,
says Dr Lustig. Unprocessed items, the things you cook yourself. A piece of
fish is real food; a fish stick is not. We have to feed ourselves and our
children accordingly. And we can effect change in the food and beverages
industry. Advocacy on the part of ordinary citizens got cigarettes out of
restaurants, airplanes, workplaces and schools. We have to do the same
when it comes to the avalanche of sugar in our food supply, Dr Lustig
continues.If we dont stop poisoning our systems with sugar, we and our
children will only get fatter and sicker. And the costs will be astronomical.