Nature. 2012 Feb 1;482(7383):27-9. doi: 10.1038/482027a.
Public health: The toxic truth about sugar.
Lustig RH, Schmidt LA, Brindis CD.
Department of Pediatrics, University of California, San Francisco, California 94143, USA. firstname.lastname@example.org
"The possible dream
Government-imposed regulations on the marketing of alcohol to young people have been quite effective, but there is no such approach to sugar-laden products. Even so, the city of San Francisco, California, recently banned the inclusion of toys with unhealthy meals such as some types of fast food. A limit — or, ideally, 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. Promotion of healthy foods in US low-income programmes, such as the Special Supplemental Nutrition Program for Women, Infants and Children and the Supplemental Nutrition Assistance Program (also known as the food-stamps programme) is an obvious place to start. Unfortunately, the petition by New York City to remove soft drinks from the food-stamp programme was denied by the USDA.
Ultimately, food producers and distributors must reduce the amount of sugar added to foods. But sugar is cheap, sugar tastes good and sugar sells, so companies have little incentive to change. Although one institution alone can't turn this juggernaut around, the US Food and Drug Administration could “set the table” for change8. To start, it should consider removing fructose from the Generally Regarded as Safe (GRAS) list, which allows food manufacturers to add unlimited amounts to any food. Opponents will argue that other nutrients on the GRAS list, such as iron and vitamins A and D, can also be toxic when over-consumed. However, unlike sugar, these substances have no abuse potential. Removal from the GRAS list would send a powerful signal to the European Food Safety Authority and the rest of the world.
Regulating sugar will not be easy — particularly in the 'emerging markets' of developing countries where soft drinks are often cheaper than potable water or milk. We recognize that societal intervention to reduce the supply and demand for sugar faces an uphill political battle against a powerful sugar lobby, and will require active engagement from all stakeholders. Still, the food industry knows that it has a problem — even vigorous lobbying by fast-food companies couldn't defeat the toy ban in San Francisco. With enough clamour for change, tectonic shifts in policy become possible. Take, for instance, bans on smoking in public places and the use of designated drivers, not to mention airbags in cars and condom dispensers in public bathrooms. These simple measures — which have all been on the battleground of American politics — are now taken for granted as essential tools for our public health and well-being. It's time to turn our attention to sugar."