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Welcome to PSR's Environmental Health Policy Institute, where we ask questions -- then we ask the experts to answer them. Join us as physicians, health professionals, and environmental health experts share their ideas, inspiration, and analysis about toxic chemicals and environmental health policy.

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Sugar-Coating Science: How the Food Industry Obscures Sugar’s Impact on our Health

Posted on September 22, 2014

By Christina Carlson

Walking into a grocery store in the U.S. is a rich sensory experience.  The customer is greeted with aisles and aisles of pasta sauces, cereals, salad dressings, beverages, spreads and breads.  The variety of each of these products is equally astounding.  But when it comes to making healthy choices, what options do we really have? Flip over any of the aforementioned products, read the nutrition facts label, and look for a theme: they all probably contain sugar—and lots of it. This is no accident. The conscious efforts of food companies have ensured that we continue to consume high amounts of sugar, and they have interfered with decision makers’ efforts to develop science-informed policies on sugar.  They have created a perfect storm of policy influence, with detrimental effects on the public’s health.

Overconsumption of sugar is bad for our health

An ever-growing body of evidence shows a causative relationship between the overconsumption of added sugars and the rise in obesity and chronic metabolic syndrome, including diabetes, high triglycerides, hypertension, and cardiovascular disease (Te Morenga, Mallard, and Mann 2013; Basu et al. 2013; Yudkin 2012; Lustig, Schmidt, and Brindis 2012; Tappy 2012; Johnson et al. 2009; Bray, Nielsen, and Popkin 2004). This association between sugar and metabolic disease is found separate from sugar’s effect on total caloric intake and exclusive of its effect on obesity (Yang et al. 2014). Yet the average American consumes at least twice the amount of added sugar—that is, any sugar not naturally occurring in a whole food that is added to a product, from cane sugar to high fructose corn syrup (HFCS)—as the American Heart Association’s recommended daily limit (AHA 2009). These metabolic conditions, once thought of as adult diseases, are becoming an epidemic among our nation’s children (CDC 2013).

With the mounting evidence and awareness about sugar’s negative effects, why do we consume so much? A major reason is that sugar lurks everywhere.  It is often hidden in processed foods not typically thought of as sweet. The food industry takes advantage of sugar’s taste and craving potential to keep consumers coming back for more, promoting these products as healthy with buzzwords like “fiber” and “protein” that distract consumers from the high sugar content.

Industry interests misrepresent, obscure the science

Sugar interests—food and beverage companies and their trade associations—have gone beyond deceptive marketing tactics to keep growing the American sweet tooth. These companies and groups misrepresent and obscure the science about sugar and our health, keeping sugar in our diets and dollars in their pockets.

“Fact sheets” on company  and trade group websites, along with industry-funded spokesperson-scientists, cast doubt on the validity of findings that link sugar to disease, playing up nonexistent confusion to distract consumers from the clear evidence that we should eat less sugar. In a strategic memo, the Sugar Association, which represents sugar beet and cane growers and refiners, explicitly suggests that its members “question the existing science” as a tactic (SA v. CRA 2013).

The public trusts doctors, scientists, and public health professionals to give them accurate information. Some sugar interests exploit this trust by deploying their own experts to spread misinformation about sugar’s health impacts.  For instance, the Corn Refiners Association (CRA), which represents HFCS interests, paid two scientists (to whom they referred as “hired guns” in internal emails) to convey the CRA’s talking points to colleagues in the field, get media quotes, and conduct their own research that aligned with CRA’s positions (SA v. CRA 2013).  Furthermore, in response to an inconvenient academic paper, the CRA considered conducting its own study to counter the findings. If that research did not support their desired position, one consultant wrote, “we can just bury the data” (SA v. CRA 2013).

Undermining public health policy

Beyond confusing the public about the health effects of their products, sugar interests also engage politically to ensure policies are not enacted that will hurt their bottom line. Some sugar industry representatives lobby policy makers and donate to members on relevant committees. A striking example came in 2009 with talks of a federal tax on sugar-sweetened beverages. That year, the American Beverage Association, which represents major soda interests, poured $18 million into lobbying to oppose such a bill -- a 28-fold increase over its previous year’s spending. A bill containing a beverage sugar tax was never introduced.

Industry also engages in agency rulemaking processes that would limit sugar intake. With the Healthy Hunger Free Kids Act of 2010, the USDA reauthorized important school meal programs and updated nutrition standards in schools for the first time in 15 years.  Among other things, it proposed a limit on the amount of sugar served in schools. In the rule’s public comment period, some industry groups weighed in, offering comments including clear misinformation. In its comments, General Mills stated that, with the exception of dental caries, “sugar intake has not been shown to be directly associated with obesity or any chronic disease or health condition” while arguing for a more lenient sugar standard (General Mills 2013).

Toward Science-informed Sugar Policy

Currently, sugar interests are watching closely as the Food and Drug Administration updates the Nutrition Facts label. The proposed updates include explicitly listing “added sugars” separately from total sugars on the label. This would allow consumers to know how much of the sugar in their yogurt comes from the lactose in the milk and how much is sugar swirled in with the French vanilla flavoring.

The scientific evidence is getting stronger that too much sugar is bad for our health. More efforts are being made to create and implement science-based policies that support healthy food environments. But sugar industry interests that seek to undermine science and block policy efforts should be held accountable by experts, investors, decision makers, the media, and the public. Our food policies should support public health, not business interests.

References

American Heart Association (AHA). 2009. Dietary sugars intake and cardiovascular health: A scientific statement from the American Heart Association. Dallas, Texas. Accessed March 20, 2014.

Basu, S., P. Yoffe, N. Hills, and R.H. Lustig. 2013. The relationship of sugar to population-level diabetes prevalence: An econometric analysis of repeated cross-sectional data. PLOS ONE 8(2):e57873. DOI:10.1371/journal.pone.0057873. Accessed April 1, 2014.

Bray, G.A., S.J. Nielsen, and B.M. Popkin. 2004. Consumption of high-fructose corn syrup in beverages may play a role in the epidemic of obesity. American Journal of Clinical Nutrition 79(4):537–543. Accessed April 1, 2014.

Center for Disease Control and Prevention (CDC). 2013. Diabetes Public Health Resource: Children and Diabetes. Accessed September 12, 2014.

General Mills. 2013. Comments on National School Lunch and School Breakfast Programs: Nutrition Standards for All Foods Sold in School, as Required by the Healthy, Hunger-Free Kids Act of 2010. Document FNS-2011-0019. Comment ID FNS-2011-0019-3716. Washington, DC: Food and Nutrition Service.

Johnson, R.J., S.E. Perez-Pozo, Y.Y. Sautin, J. Manitius, L.G. Sanchez-Lozada, D.I. Feig, M. Shafiu, M. Segal, R.J. Glassock, M. Shimada, C. Roncal, and T. Nakagawa. 2009. Hypothesis: Could excessive fructose intake and uric acid cause type 2 diabetes? Endocrine Reviews 30(1):96–116. DOI:10.1210/er.2008-0033. Accessed April 1, 2014.

Lustig, R.H., L.A. Schmidt, and C.D. Brindis. 2012. Public health: The toxic truth about sugar. Nature 482(7383):27–29. DOI:10.1038/482027a.

Sugar Association v. the Corn Refiners Association (SA v. CRA). History of the case. 2013. Accessed March 7, 2014.

Tappy, L. 2012. Q&A: “Toxic” effects of sugar: Should we be afraid of fructose? BMC Biology 10(1):42. DOI:10.1186/1741-7007-10-42.

Te Morenga, L., S. Mallard, and J. Mann. 2013. Dietary sugars and body weight: Systematic review and meta-analyses of randomised controlled trials and cohort studies. BMJ 346(3):e7492. DOI:10.1136/bmj.e7492. Accessed April 1, 2014.

Yang, Q., Z. Zhang, E.W. Gregg, W. Flanders, R. Merritt, and F.B. Hu. 2014. Added sugar intake and cardiovascular diseases mortality among US adults. JAMA Internal Medicine 174(4):516–524. DOI:10.1001/jamainternmed.2013.13563. Accessed March 10, 2014.

Yudkin, J. Pure, white and deadly. 2012. London: Penguin. Accessed March 28, 2014.

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