It's
addictive and toxic, like a drug, and we need to wean ourselves off it, says US
doctor
The Guardian, Sarah Boseley, health editor, Wednesday 20 March 2013
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| Dr Robert Lustig's book Fat Chance: The Bitter Truth About Sugar has caused a backlash from the food industry, which, he says, wants to 'paint me as this zealot'. Photograph: Alamy |
Sugar –
given to children by adults, lacing our breakfast cereals and a major part of
our fizzy drinks – is the real villain in the obesity epidemic, and not fat as
people used to think, according to a leading US doctor who is taking on
governments and the food industry.
Dr Robert
Lustig, who was this month in London and Oxford for a series of talks about his
research, likens sugar to controlled drugs. Cocaine and heroin are deadly
because they are addictive and toxic – and so is sugar, he says. "We need
to wean ourselves off. We need to de-sweeten our lives. We need to make sugar a
treat, not a diet staple," he said.
"The
food industry has made it into a diet staple because they know when they do you
buy more. This is their hook. If some unscrupulous cereal manufacturer went out
and laced your breakfast cereal with morphine to get you to buy more, what
would you think of that? They do it with sugar instead."
Lustig's
book, Fat Chance: The Bitter Truth About Sugar has made waves in America and
has now been published in the UK by 4th Estate. As a paediatrician who
specialises in treating overweight children in San Francisco, he has spent 16
years studying the effects of sugar on the central nervous system, metabolism
and disease. His conclusion is that the rivers of Coca-Cola and Pepsi consumed
by young people today have as much to do with obesity as the mountains of
burgers.
That does
not mean burgers are OK. "The play I'm making is not sugar per se, the
play I'm making is insulin," he says. Foodstuffs that raise insulin levels
in the body too high are the problem. He blames insulin for 75% to 80% of all
obesity. Insulin is the hormone, he says, which causes energy to be stored in
fat cells. Sugar energy is the most egregious of those, but there are three
other categories: trans fats (which are on the way out), alcohol (which children
do not drink) and dietary amino acids.
These amino
acids are found in corn-fed American beef. "In grass-fed beef, like in
Argentina, there are no problems," he said. "And that's why the
Argentinians are doing fine. The Argentinians have a meat-based diet … I love
their meat. It is red, it's not marbled, it's a little tougher to cut but it's
very tasty. And it's grass-fed. That's what cows are supposed to eat – grass.
"We
[in the US] feed them corn and the reason is twofold – one, we don't have
enough land and, two, when you feed them corn they fatten up. It usually takes
18 months to get a cow from birth to slaughter. Today it takes six weeks and
you get all that marbling in the meat. That's muscle insulin resistance. That
animal has the same disease we do, it's just that we slaughter them before they
get sick."
But his
bigger message is that cheap sugar is endangering lives. It has been added to
your diet, "kids have access" to it, and it is there in all sorts of
foods that don't need it, he says. When high-fat foods were blamed for making
us overweight, manufacturers tumbled over each other to produce low-fat
products. But to make them palatable, they added sugar, causing much greater
problems.
Cutting
calories is not the answer because "a calorie is not a calorie". The
effect of a calorie in sugar is different from the effect of a calorie in lean
grass-fed beef. And added sugar is often disguised in food labelling under
carbohydrates and myriad different names, from glucose to diastatic malt and
dextrose. Fructose – contained in many different types of sugar – is the
biggest problem, and high-fructose corn syrup, used extensively by food
manufacturers in the US, is the main source of it.
Lustig says
he has been under attack from the food industry, but claims they have not
managed to fault the science. "The food industry wants to misinterpret
because they want to discredit me. They want to paint me as this zealot. They
want to paint me as somebody who doesn't have the science. But we do," he
says.
Evidence of
dietary effects on the body is very hard to collect. People habitually lie in
food diaries or forget what they ate. Randomised controlled trials are
impossible because everyone reverts to a more normal eating pattern after a
couple of months. But his sugar argument is more than hypothesis, he says,
citing a recent study in the open journal Plos One, of which he was one of the
authors. It found that in countries where people had greater access to sugar,
there were higher levels of diabetes. Rates of diabetes went up by about 1.1%
for every 150 kcal of sugar available for each person each day – about the
amount in a can of Coke. Critics argued sugar availability was not the same as
sugar consumed, but Lustig and his colleagues say it is the closest
approximation they could get.
That study
was aimed at the World Health Organisation although he believes it is a
conflicted organisation.
But so is
the US government, he says. "Government has tied its wagon to the food
industry because, at least in America, 6% of our exports are food. That
includes the legislative and executive branches. So the White House is in bed
with the food industry and Congress apologises for the food industry."
Michelle
Obama appeared to be onside when she launched her Let's Move initiative in
February 2010 with a speech to the Grocery Manufacturers Association of
America. "She took it straight to them and said, 'You're the problem.
You're the solution.' She hasn't said it since. Now it's all about exercise.
"Far
be it from me to bad-mouth somebody who wants to do the right thing. But I'm
telling you right now she's been muzzled. No question of it." In his book
he tells of a private conversation with the White House chef, who he claims
told him the administration agreed with him but did not want a fight with the
food industry.
Some areas
of the food industry have appeared to be willing to change. PepsiCo's chief
executive officer, Indra Nooyi, who is from India which has a serious diabetes
epidemic, has been trying to steer the company towards healthier products. But
it has lost money and she is said to be having problems with the board.
"So here's a woman who is trying to do the right thing and can't," he
says.
Court
action may be the way to go, he says, suggesting challenging the safety of
fructose added to food, and food labelling that fails to tell you what has been
added and what has been taken out. Fruit juice is not so healthy, he says,
because all the fibre that allows the natural sugars to be processed without
being stored as fat has been removed. Eat the fruit, he says, don't drink the
juice. Lustig is taking a master's at the University of California Hastings
college of law, in order to be a better expert witness and strategist.
It is not a
case of eradicating sugar from the diet, just getting it down to levels that
are not toxic, he says. The American Heart Association in 2009 published a
statement, of which Lustig was a co-author, saying Americans consumed 22
teaspoons of it a day. That needs to come down to six for women and nine for
men.
"That's
a reduction by two thirds to three quarters. Is that zero? No. But that's a big
reduction. That gets us below our toxic threshold. Our livers have a capacity
to metabolise some fructose, they just can't metabolise the glut that we've
been exposed to by the food industry. And so the goal is to get sugar out of
foods that don't need it, like salad dressing, like bread, like barbecue
sauce." There is a simple way to do it. "Eat real food."
Does he
keep off the sweet stuff himself? "As much as I can. I don't go out of my
way. It finds me but I don't find it. Caffeine on the other hand …"
Lustig's
food advice
• Oranges.
Eat the fruit, don't drink the juice. Fruit juice in cartons has had all the
fibre squeezed out of it, making its sugars more dangerous.
• Beef.
Beef from grass-fed cattle as in Argentina is fine, but not from corn-fed
cattle as in the US.
•
Coca-Cola, Pepsi and other sweetened beverages. These deliver sugar but with no
nutritional added value. Water and milk are the best drinks, especially for
children.
• Bread.
Watch out for added sugar in foods where you would not expect it.
• Alcohol.
Just like sugar, it pushes up the body's insulin levels, which tells the liver
to store energy in fat cells. Alcohol is a recognised cause of fatty
liver disease.
•
Home-baked cookies and cakes. If you must eat them, bake them yourself with one
third less sugar than the recipe says. Lustig says they even taste
better that way.
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| Who is responsible for making us fat? Photograph: Pat Doyle/Corbis |
