Last September, for the first time in human history, the UN declared chronic non-communicable diseases as a greater health burden worldwide than infectious diseases. This is a worldwide issue, with trends indicating that countries who have adopted Westernized diets (low cost, highly processed foods) are suffering from higher rates of obesity and related diseases.
Although obesity often is thought of as the root cause of the increase of non-communicable diseases, stats indicate that there are other culprits. Since 20% of obese people have normal metabolism and will have a normal lifespan while 40% of normal-weight people will develop the diseases that constitute the metabolic syndrome indicating that obesity is not the main culprit. Obesity is not a cause, but a marker for metabolic dysfunction. The announcement from the UN targets tobacco, alcohol and diet as the central risk for non-communicable diseases, yet governments are only regulating 2 (tobacco, and alcohol) to protect public health. The regulation of tobacco and alcohol, being that they are non-essential consumables, is easier than regulating food; a required human need. What needs to be questioned is which aspect of the Western diet should be the focus of intervention?
The consumption of sugar has tripled worldwide in the past 50 years. Countries are relying on high fructose corn syrup (HFCS) and sucrose- equal parts glucose and fructose mixtures. Sugar is not just “empty calories”. Scientific evidence has showing that fructose can trigger processes that lead to liver toxicity and other chronic diseases. International bodies must consider limiting fructose, HFCS, and sucrose as they pose a major threat to individuals and society as a whole. Our whole food system is saturated with sugar laden foods. As discussed in an earlier post corporate giants are saturating the global food market with toxic levels of glucose.
If one applies the same criteria that are widely accepted by the public-health community to justify the regulation of tobacco and alcohol, sugar consumption warrants some form of social intervention. There are 4 criteria:
1) Unavoidable (pervasiveness in society)
Sugar was only available to our ancestors for a couple of months per year at harvest time or as honey. Now, sugar is just about added to all processed food. On average we are consuming 500 calories of added sugar per day.
Epidemiological evidence suggests that excessive sugar impacts ones health more than just adding excessive calories but also induces all of the diseases associated with metabolic syndrome- hypertension, high triglycerides, insulin resistance, diabetes, aging. It can also be argued that fructose exerts toxic effects on the liver that are similar to those of alcohol. This is no surprise since alcohol is derived from the fermentation of sugar. Some early studies have also linked sugar consumption to human cancer and cognitive decline.
3) Potential for abuse
Like alcohol and tobacco, sugars act on the brain to encourage increased intake. Sugar consumption suppresses the hormone ghrelin (signals hunger in the brain) and interferes with the normal signals of leptin (feeling of satiety).
4) Negative impact on society
Just as dunk driving and second hand smoking are reasons for alcohol and tobacco control, high sugar consumption has a long term economic, healthcare, and human cost of metabolic syndrome lending to reasons for higher levels of government control. In the US, 75% of healthcare dollars are being spent on treating metabolic diseases and their resultant disabilities.
HOW TO INTERVENE
Sugar is a naturally occurring nutrient, but in excess it can become toxic. When looking at successful tobacco and alcohol control strategies,there have been propositions to add taxes to processed foods (sugar-sweetened beverages, sugared cereals). Already, Canada and European countries have imposed small additional taxes on some sweetened foods. Another strategy is to limit hours of distribution through retailors and who can legally purchase the products. With sugar, a parallel approach to this would mean tightening licensing requirements on vending machines and snack bars that sell sugary products in schools and workplaces. But the question still exists as to the efficacy of this approach.
POSSIBLE DREAMS FOR CHANGE
Government-imposed regulations on the marketing of alcohol to young people have been quite effective, but there is no attempt to follow suite with sugar. A limit, or ideally a ban, on television commercials for products with added sugars could further protect children’s health. Reduced fructose consumption could also be fostered through changes in subsidization towards more wholefoods instead of processed foods.
Ultimately, it comes down to a need for food producers and distributors to commit to reducing the amount of sugar added to foods. Large government food agencies (ex:FDA, Health Canada) must commit to adjusting regulations and consider removing fructose from the Generally Regarded as Safe List (GRAS) that allows manufacturers to add an unlimited amounts of sugar to any food. This larger industry change must be initiated through regulations because sugar is cheap, sugar tastes good, and sugar sells, so companies have little incentive to change unless required by policies.
Reducing sugar will not be easy, especially within the emerging markets of developing countries where soft drinks are often cheaper than potable water or milk. For change to happen, all stakeholders must become actively engaged. Population wide alterations to sugar consumption can occur just as bans on smoking in public spaces and the use of designated drivers has become the norm. With enough clamor for change, major adjustments with policy becomes possible. It is critical for attention to be put towards sugar and its consumption in order to improve the state of public health and well being of populations .
Information from this post comes from an article in Nature titled The toxic truth about sugar.