On Thursday, high-profile science journal Nature published a commentary by three academics, which argued that sugar is a toxin and that it should be subject to similar kinds of public-health interventions as alcohol. In other words, sugar should be taxed and restricted just like booze.
One of the authors, Robert Lustig, runs an obesity clinic at a children’s hospital, part of the University of California, San Francisco. His colleagues and fellow authors, Laura Schmidt and Claire Brindis, are researchers in healthy policy. Lustig has gained an online following since 2009 for a lecture entitled ‘Sugar: the Bitter Truth’ (watch it here). While Lustig’s tone is rather melodramatic, there does appear to be a growing body of evidence linking refined carbohydrates and a group of related symptoms – obesity, fatty liver disease, type-2 diabetes and cardiovascular disease – that come together under the broad umbrella of ‘metabolic syndrome’.
It’s certainly the case that these chronic diseases have increased in importance in recent decades (in part because of the decline of infectious disease). Consumption of refined carbohydrates – particularly sugar – has increased, too. America has a particularly sweet tooth; the average American consumes 131 pounds (about 59 kg) of sugar and high-fructose corn syrup (HFCS) per year, up from 113 pounds per person in 1966. A teaspoon of sugar weighs about 4g, so this amounts to 40 teaspoons per person per day. (And remember, that’s an average – some people are consuming considerably more.)
The UK has a pretty sweet tooth, too. A survey for the Food Standards Agency in Scotland in 2008 found that 17 per cent of children’s calorie intake was coming from ‘non-milk extrinsic sugars’ – that is, table sugar and sugar added to food. That adds up to about 20 teaspoons per child per day.
So, we have rising rates of diseases related to metabolic syndrome alongside increased sugar consumption. Sucrose (the kind used as table sugar) and HFCS are regarded as particularly problematic by many researchers because they are both mad up of two simpler sugars, glucose and fructose. Glucose induces the production of insulin and would seem, therefore, to be a reasonable suspect in problems of insulin resistance and diabetes, with knock-on effects to do with obesity. Fructose, though it sounds healthy because it is also found in fruit, is practically Public Enemy No.1 for some health researchers due to its effects on the liver and in relation to heart disease. Thus, some see the consumption of sucrose and HFCS as a dietary double-whammy that significantly increases the risk of a number of chronic diseases.
But while there is a body of evidence that suggests sugar and HFCS are culprits in some common health problems, the appeal for government action is illiberal and wrong-headed. It’s one thing to advise the population on what may be good or bad for our health. Many people have chosen to quit smoking, for example, for health reasons even though they enjoy it. But it is quite another thing to demand that adults should change their habits at the whim of medical researchers, politicians or campaigners.
How we lead our lives should be our choice. If we enjoy smoking, drinking or sugary foods and drinks, it is up to us to balance up any possible health risk against the pleasures that we may forego. After all, for most people, these chronic health problems are largely diseases of old age. We may well decide to ‘live fast and die a bit younger’. Yet the trend in recent years has been to take that choice out of our hands – through bans on smoking, for example – or to punish us financially for making the ‘wrong’ choices through what are, effectively, sin taxes. This policy trend robs us of our freedom and infantilises us, reducing valid adult choices to the equivalent of childish misbehaviour.
If Lustig and his colleagues are right about sugar, then they should put the arguments forward and convince us. We’re not stupid, and we can take on board sound medical advice (especially if it is not polluted by petty politics). But when it comes to bans, taxes and other restrictions on sugar, we should do sweet FA.