A Case for Regulating Sugar Like Alcohol

Robert Lustig on reining in what's toxic, addictive, and everywhere

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Substances like alcohol are regulated according to four criteria. For a government to take that big step on behalf of its citizens, a substance must:

1. Be ubiquitous

2. Be toxic

3. Be addictive

4. Have a negative impact on society

There is, according to Robert Lustig, a substance that fits the bill times four -- save for the fact that it is not currently regulated. And that is sugar. Specifically, fructose. In a conversation with The Atlantic's Corby Kummer at the Aspen Ideas Festival today, Lustig -- a pediatric endocrinologist who doubles as a sugar detractor -- made the case.

Sugar, Lustig noted, is obviously ubiquitous. It has an obvious negative impact on society, given the obesity and diabetes epidemics that have caused so much anxiety in the United States. Sugar is also, Lustig argued, toxic: the mitochondria in our bodies' cells, he said, are unable to convert the excess fructose we eat into energy, so they convert it instead into liver fat. That in turn starts a cascade, causing the insulin resistance that can lead to chronic metabolic disease -- which can lead in turn to diabetes, heart disease, and possibly cancer. A study that Lustig and his colleagues conducted, which was published in the journal PLoS this February, suggested that diabetes is caused not by obesity, as is sometimes thought, but by sugar itself. Even the scientist who won the 1923 Nobel Prize for the discovery of insulin warned that high sugar consumption could be linked to diabetes. As Lustig put it during the talk, "25 percent of all the [Type 2] diabetes in the world is explained by sugar and sugar alone."

Bolstering the case for regulation, Lustig says, is the fact that sugar is addictive. Fructose, Lustig claims, can dampen the suppression of the hormones that signal both hunger and satisfaction to the brain -- which means that the more we eat, the less likely we are to feel satiated. So the more likely we are to want more. (And more, and more, and ...)

Regulation, of course, is always fraught. Regulating something like sugar would be especially tricky. Of the four regulation criteria Lustig listed, the only one that isn't really open to argument is the first: sugar's utter ubiquity. There's also the sugar lobby. There's also the fact that sugar, for consumers, tends to be cheap. There's also the fact that sugar, in many of its forms, tends to be delicious.

Still, "everyone's looking for a nutritional villain," The Atlantic's Cummer noted; we're all looking for what he called "a kind unified field theory" about what causes childhood obesity and so many of the other health problems the U.S. is facing right now. The more we learn, the more it seems that sugar is at least a component of that unified theory. And if Lustig gets his way -- if people do come to see sugar as a substance that can be abused -- public awareness might offer its own kind of regulation. Sugar, Lustig put it, is "great for your wallet, but crappy for your health." The companies that profit from its sales might not, at the moment, have an incentive to change their ways; the more the public learns about sugar's effects, though, the more we might limit our intakes of the stuff. Voluntarily.