Sugar: Slow Death or Little Death? Part 1

Mayor Bloomberg of New York was recently stunned to find out that his signature health initiative had been blocked by a New York Supreme Court judge. The judge cited inequities specific to what businesses a 16-ounce limit on sugary beverages would apply. Restaurants, for example, would have to comply in reducing the size of their glasses but not in the number of refills; convenience stores that do not prepare food on the premises were exempted entirely from the ban. Prior to the anticipation of the ban actually being enacted, Mayor Bloomberg had taken his case to the media, both locally and nationally. His administration even went so far as to suggest that other governing bodies follow their example by enacting similar bans. Although other municipalities elsewhere are presently considering such measures, New York City would have been the first to pilot this kind of regulation at the legal level.

Critics of the ban, predictably the American Beverage Association but also notably the NAACP as well as a significant portion of New Yorkers, breathed a sigh of relief after the decision. In an amicus brief the coalition noted as primary grievances an infringement on individual liberty as well as an unfair regulation of local businesses in light of exemptions for state and nation-wide chains such as 7-11 and McDonalds.

Mayor Bloomberg has already succeeded in limiting the salt content of food prepared and served in the city so his proposal was nothing new to residents. That a group whose constituents disproportionately suffer from obesity teamed up with a corporate proxy was a stark reminder that awareness of the link between obesity and sugary drinks still has a very long way to go.

That awareness has perhaps an even steeper hill to climb if you ask Dr. Robert Lustig, Pediatric Endocrinologist and Professor of pediatrics at UCSF. His vocal advocation of such additives as High-Fructose corn syrup in beverages as a “poison” have earned him a notable position in media interviews around the country. Even Dr. Lustig, however, conceded that Mayor Bloomberg’s proposal won’t “solve obesity” but that it was a “baby step,” in an interview with CBS News.

In his 2009 lecture, “Sugar: The Bitter Truth” at UCSF, Dr. Lustig remarks that in its wide-spread processed form, the sugar Americans ingest has not only become disastrous to our health in a multitude of regards, but has become the most overlooked factor in trying to solve the national obesity epidemic, now estimated to affect 35% of the population within an overall 68% estimated to be overweight.

Although the Youtube video of his lecture now has well over 3 million views, a 1-hour and 29-minute watch can be daunting for many who do not already have an interest in the details of the issue.

Is sugar a poison? Among the many points of his argument is a comparison of processed high-sugar content beverages to alcoholic beverages. In the same way that the metabolism of a beer gets displaced to the liver thus causing debilitating effects to one’s health through chronic use, beverages with high sucrose content like soda  also resist the naturally designated organs for breaking down sugars: the stomach and intestinal tract. When sugar winds up in the liver, it catalyzes a process called denovo lipogenesis, i.e. the transformation of sugar directly into fat. Sugars found in nature, Dr. Lustig points out, get burned as energy before ever reaching the liver because they are paired with fiber. Sugar in the liver begins to look a lot like alcohol in the liver and, shockingly, carries with it 8 out of the 12 most common health defects associated with alcoholism – not to mention a direct link to type 2 diabetes.

But what about moderation? Isn’t it common knowledge that alcohol in moderate doses causes minimal harm to longevity and may even produce health benefits? Not so for the likes of HFC’s; such refined sugars actually cause an addiction even more potent than that of alcohol wherein the body is tricked into thinking it is hungrier than it should be long after the ingestion has taken place. The key element, Dr. Lustig explains, is the hormone, Leptin, which becomes inhibited by the speedy transport of fructose into the liver.

The case against sugar on the grounds of fitness is an easy one. First Lady Michelle Obama has elevated youth fitness to a national priority; the revamped labeling of nutrition facts was in large part due to her work and is set to be expanded this year by the FDA. Binding regulation of fitness, however, has no precedent in U.S. law; at most, organizations like the American Heart Association or even the Surgeon General (currently absent) issue guidelines about eating healthy and regimenting exercise.

Dr. Lustig comments at one point in the lecture that “You wouldn’t think twice about not giving your kid a Budweiser but you don’t think twice about giving your kid a can of Coke – but they’re the same.” The regulation of alcohol is well established as within the purview of government. The case against unlimited alcohol content, however, has less to do with overall fitness concerns than its potential to intoxicate and thereby cause great harm. If intoxication is what justifies a ban, finding an example of a “sugar rampage” might be a major roadblock in the effort to ban sweeteners.

Another obstacle not only facing a ban but other regulatory measures as well is political donations. In the 2012 election cycle, the Coca-Cola Corporation donated $20,700 to New York state legislators via its New York Political Action Committee (PAC) and an additional $13,500 to at-large New York congressman and one senator via its Federal Pac (source: http://assets.coca-colacompany.com). The Purchase, NY-based Pepsi Co. gave $46,500 to New York Congressmen and one senator via its own PAC (source: http://www.opensecrets.org). These donations were not without reason; New York Governor Andrew Cuomo remarked last summer of the proposed soda ban, “I don’t think you can do a lot of harm in the interim, as I said, I think you can only do good.” Despite sentiments from the governor and others, Mayor Bloomberg’s appeal is unlikely to reverse the outcome of Monday’s decision.

Will this be the last word on sugary drinks and the obesity epidemic? Highly unlikely. The idea of taxing sugar instead of banning it will be the topic for part 2 of this article.