Some people argue that sugar should be regulated, like alcohol and tobacco, on the grounds that it’s addictive and toxic. How much sense does that make? We hear from a regulatory advocate, an evidence-based skeptic, a former F.D.A. commissioner — and the organizers of Milktoberfest.
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and therefore prohibiting the consumption of among other substances, alcohol people- don't you but we still like to have a lot of fun: Roger Layton Communications manager, at the b, where you library helps produce, looked over fist, and so we just unless just embrace that, let's just enjoy it, we very energetic of german folk dancers commented perform. We brought cases in cases of chalk, milk and then, as soon as the milk was there and we said, go, it basically became a free for all. I think people love it because it is sort of kind of like tougher Festus, almost lake, be why you light or something like that. That's Brenner, old, Droid, she's, a Why you student, who helped put together knocked over first? You know like hey like this is, but we love to do All the time the chocolate melted drinking isn't just any chocolate milk at some pretty legendary chocolate milk made in view I use own creamy Chopin, the party which no one's going to complain and when it may seem little childish, but really,
people will drink it. It's it's a friendly, it save its happy and one of the great things about parting Chukka milk is like well, you probably if you're, smart and you're, not gonna, throw up later so that some plus this all sounds pretty awesome right and wholesome to swapping of beer for chocolate, milk, but is chocolate, milk, real as wholesome as it seems. You know how much sugar there is in one cup of chocolate, milk. The answer is twenty four grams. It's a bit. More than you'd, find in the same amount of soda, and there are those who argue that the detriment of sugar. Well, they do is it from a metabolic standpoint at least milked over fest isn't much better than Opto professed we started comparing what sugar did burst.
What alcohol didn't realize you know what sure now alcohol do the exact same thing. If you ve been following health news in the last decade, you ve likely noticed war on sugar and alarming rise in the rate of obesity and related health problems, has prompted a nationwide movement to banned, restrict sugary drinks. How justified is that war? Today's episode was inspired by a question we received freak, and my name is all- are now I'm in eleven year old listener from Chicago and I was wondering why sugar isn't considered a drug, even though its addictive and stimulates the brain sincerely saw ok, Saul boudoir best answer your question. Along the way we will learn some sugar history, Thomas Aquinas way back in the thirties. He pronounced sugar. A medicine will hear from some people who fully agree with you now: alcohol,
tobacco morphine and heroin clearly meet. These four criteria will also hear from some people who don't agree with you. We no clue, no real good evidence that it's gonna do any good whatsoever and we're here, all about your sugar habits. I gave it up once they didn't work. I am addicted to sugar. I can't help it from stature and definite productions. This is frequent mix, radio, the path cast. It explores the hidden side of everything. Here's your host, Stephen Governor we get into the nitty gritty on sugar. Let me offer a sort of caviar
in general. Nutrition studies are not very robust compared to the other fields in biological science, that's Richard Con, I'm the former chief, scientific and medical officer with American Diabetes Association. So, what's the problem with nutrition studies there no controls, no ran imitation. Small number of subjects is very difficult to conduct very rope. US long term. Studies on the Chechen okay. This is a really important points can think we talk about all the time on this point, the legitimacy of data yadda yadda, but with nutrition? There are few things going on to make a particularly tough number one. This is about some in that we all put in our mouths every day, which means we all think of ourselves as experts unlike particle,
exhort financial engineering. This is something we all do all the time. So, of course, we know what we're talking about number do most nutrition. Science is built on survey data that is asking people about what they beaten or asking them to keep food diaries. Things like that that you ve been paying any attention at all. Four connects radio over the years. You know this is a sure fire way to gather some, not so realistic, or at least not so robust data, and so as Richard concept. Can be a real challenge to run a really convincing nutrition study, because people do not want to dissipated. I want to alter their dye patterns for a long time and they don't comply with the regiment of the instructions in the randomized trial? Now, if we could take a few thousand people,
randomize them and then control every single thing they ate and drank for a few years might be great but absent that we do our best. We look for data, we ask questions starting here So as a public health official in New York and at the national level, you ve tried to stem aids in TB and pandemic flu. You ve tried to prepare the public for potential bioterrorist attack. How, in light of those dangers, would you rank? Let's say the consumption of sugar? Well, there very different threats, but I think we have to I that, while acute public health crises, you know really demand all of our attention and get a lot of response that how we live, what we eat. If we exercise many aspects
of our daily lives, have the greatest impact on health and disease. Its Margaret Hamburg, I M a medical doctor and a public health professional. Who has I served in government at many levels over many years now and as recently as the? U S FDA, commissioner, I wanted to ask you briefly about some FDA definitions that when I read them, I have to say that they are somewhere between comical and incomprehensible when the FDA defines food, food additives, drugs and then substances generally regarded as safe, so those it the categories which of these definitions apply to sugar, Edith. I have to agree with you that many of the definitions are about. I didn't mean to lie, assumed even run. I
now in areas between you ever wrote them in the wrong grasses responsible for some of it and FDA lawyers. For some of it, course in a many of these laws then regulations and guidance and definitions have evolved, over many many years yet, but it is located in confusing, and it's why the you know since many lawyers as scientists, if you like, for instance, the first, the very first thing food number one articles used for food or drink or man or other animals, so, like you were talking about how you could have a nutritious, sawdust? I can imagine that could easily fit within FDA deregulation, EFTA guidelines, then it I'm used for food. It's it's really hard. To answer a question like the one you just post. To me I mean sugar.
Is intrinsic to many food products, so it's not gonna be regulated the same way that a completely exam genus additive to a food product can be regulated and but so technically, the categories under which sugar falls However, our food additive, an Jerry S, regarded as safe and not food itself correct. Well, this is my point. And I am not going to answer your question as it has- I dont of my lawyers here, but no I mean you know, there's there are sugars in fruit and vegetables, their sugars in in dairy products
their sugars and various grasses that that people consume. So you know it's its intrinsic to the food product itself. For instance, let's get back to chocolate milk from it. As we said, got twenty four grams of sugar per one cup serving more than some soda, but regular old milk without the chocolate is about twelve grams of sugar, naturally sweet from the lactose, then there's the sugar. Its added to many foods products that you think are actually very healthy. You know yogurt the lever the sugar are astonishing hi things like barbecue, sauce and spaghetti sauce and soup actually have much. Our levels of sugar than you ever imagine not to mention the levels that are in pies and Kate.
Some ice cream and things we would expect to see sugar so how much sugar overall do we actually consume so right now we are about State a sixty five percent over our limit and that average its Robert busted Professor pediatrics, the University of California, San Francisco School of medicine, morsel member of their institute for health policy studies. My job is to try to treat obese children and
also alter the global food supply, easy picking the low hanging fruit for yourself, I say easier, said than done on both counts the data very again Missus nutrition science we're talking about, but the most recent estimates show that Americans consume between twenty and thirty teaspoons of added sugar per day. That's down a bit from our peak consumption sometime around the early two thousands, but but still consume more added sugar than any one else. And this has turned Robert less into one of the most outspoken sugar critics. You will find he came to this position over many years. I'm a pity Again, chronology must I take care of glandular hormonal problems and children, and I was doing that pretty seamlessly for a good two to three decades. And then the kid started getting fat on me, the question was No, what's going on so wished
looking at what sugar did too body and what we realized was it caused. This thing called insulin resistance and particularly in the liver, and so we started comparing what sugar did burst What alcohol didn't realize you know what sure now alcohol do the exact same thing and makes sense that it should, because, after all, where do you get alcohol from imitation of sugar and so we are now seeing. The diseases of alcohol without the alcohol and of that started my shall we say advocacy in this field of obesity and public if you are indeed overweight or obese. You want to lose weight. The first place to start is to reduce sugar consumption. That again, is Richard Con, formerly of the American Diabetes Association.
The reason being that we get plenty of energy from other carbohydrates. We don't have to rely on sugar to get our energy and the sex. The reason is that sugar itself does not come along with any other essential nutrients. Vitamins or minerals, so you might think that con enlisted are in precisely the same camp, but there would be wrong, Well, there's no question that there is a real obesity epidemic throughout the world, so that I think is very real and very important and very serious and it some clear adverse health consequences. In addition, that has led to, I believe, has led directly to a dramatic increase in the incidence of diabetes throughout the world. We first saw this in in the United States, were sweet, seen it in european countries were now seeing it in asian countries so diverse
This is clearly a serious disease. It has quite serious complications and that's a problem. So then the question becomes what has caused the obesity epidemic and that is to use the euphemism. Let a sixty four thousand dollar question there are many potential contributors to the rise in obesity. So there's been some some evidence that with the increased use of psychic Tropic drugs, anti depressive drugs drugs. For- schizophrenia and other mental disorders. Those drugs tend to promote weight gain Another possibility is that we ve seen clearly smoking cessation in a large proportion of the population and when people stop smoking, that's usually been associated with weight gain. So second topic. Drug smoking. Cessation potential in
actions have been attributed to rise and obesity. There's also lotteries arguing the rather obvious point that we consume more calories today than we used to for a lot of reasons: the relative low cost of food, the deliciousness of food, the availability of food, especially the availability of cheap, delicious sweet food of so many people. Do you believe that sugar consumption has been the cause it has is the cause of our obesity epidemic and then subsequently diabetes. But I believe that the evidence for this is pretty weak. When the city of San Francisco wanted to add warning. Labels to soda com submitted an expert report on behalf of, among others, the American Beverage Association. He wrote quote: there is no scientific consensus that added sugar, including added sugar in beverage,
please a unique role in the development of obesity and diabetes. So if we look as an analogy, for example, to cigarette smoking and try to make the link between sugar and obesity or diabetes and cigarette smoking to cancer and say well. Ok, what's been what's the differences? Ok, what are the differences in the cigarette smoking realm the lowest smoking rate produced an enormous incidence of lung cancer? and the highest rate of smoking I was just simply off the charts in terms of the likelihood of developing lung cancer can be see with sugar consumption is less than a twofold.
Increase at the highest levels? This gets into tricky territory is concepts, as some studies do find a twofold increase in diabetes at the highest rate of sugar consumption, but other analyses, including one by Robert Lusting, argue that is considerably higher. That said, the relationship between sugar and obesity is nowhere near as strong as relationship between smoking and lung cancer. According to the National Institutes of Health, even late smoking results in nine fold increase the next one is something called temper. Quality. In other words, is there a association in time between sugar consumption and obesity, so that held pretty true from about nineteen. Eighty five to the year two thousand, where there was as obesity, was went up. Sugar someone went up, but thereafter
there, are starting in the year two thousand even to today, sugar consumption has declined somewhere around fifteen to twenty percent, whereas obesity rates continue to rise, don't see that at all with smoking, the analogous situation the red- smoking rises. Cancer rises. Cigarette smoking declines, cancer declines. This, of course, doesn't mean that sugar doesn't contribute to obesity. Just that again, the relationship isn't so definitive con points to another difference between smoking and sugar in cigarette smoking. We found a link between cigarette smoking in cancer in every population. Every ethnicity. Both genders all kinds of tobacco use and even in bystanders, conversely, in with sugar, we don't have it
consistency whatsoever, for instance, some studies show a strong relationship between weight gain, an sugar sweeten beverages espies, but that relationship is most consistent when the ss bees are consumed in addition to a person's regular diet. So the problem, I simply be the extra calories, not the sugar per se- could also be that people who drink a lot of sugary drinks do other things that lead to war. Game. There is also the fact that, as Richard Con said earlier in general, nutrition studies are not very robust compared to many other field. Was in biological science in sugar consumption, most of them there, neither no controls a very small number of subjects. They ve only lasted for days or weeks at the most then so the experimental studies have I've been robust, so in cons view, the science on sugar is not settled which mean
The notion of regulating sugar is at best premature. I dont think that there is any apps good amount of sugar that we should be under in our consumption. I think that It all relates to eating a well rounded diet to Robert Lusty. Meanwhile, the time for regulation is now
So this episode was inspired by a listener who wrote in to say, essentially you know if sugar is bad for us is a lot of people are now saying it is why isn't it regulated the way other potentially harmful substances like I'll call or tobacco are regulates? How do you answer that question? Well, the public health community has identified four separate criteria that are needed to be fulfilled before a substance can be considered for. Regulation NOS four are number one ubiquity that is can't get away from it number two toxicity that dangerous number three abuse that. Increased consumption is inherent in the molecule itself and finally, number four is extra now That is, your consumption hurts me now alcohol tobacco,
morphine and heroin a clearly meet these four criteria, and so the question Does sugar meet them and the answer is yes, it does the loosely ok. Let's look at those four criteria for sugar ubiquity. That's pretty much, no brainer! What about toxicity lust eggs hypothesis has to do with how the body handles fructose. So when you consume diet or sugar, the glucose molecules can go anywhere in the body. Only about twenty percent hit the liver, but the front does molecules have to be handled in the liver, because there's a specific transport the v five transporter. It is only in the liver. So when you, consumer soda, you are flooding your lover and your liver basically can handle the flood and
The liver has no choice but to turn that fructose into liver fat and it's that liver fat that causes the chronic metabolic disease and we have the data now that demonstrates that it's the liver, food made from dietary sugar, that is at the night us at the beginning of type to die. It is heart, disease, fatty, liver disease, and we are starting to ferret out. The links between I turn sugar and cancer and dimension as well, but I know there's other research. It says that the toxicity argument may be overstated that it's you know not an acute toxin may be, but a chronic one sure you are absolutely right that sugar is not an acute toxin, so chronic toxins are still toxins, even though they don't make a cue overnight is benzene. Toxin. We regulated as such benzene doesn't kill you acutely. What about alcohol two alcohols both it's an acute toxin, so I mean you can basically die on a bender
or its economy talks and you can fry your liver is both. The point is that the FDA regulates acute toxins because it's in there charter the food drugging, cosmetics, active Nanking, thirty, eight, very specifically, it does not say anything about chronic toxins, and so the FDA does not regulate chronic toxins criteria. Number three for regulation: the potential for abuse. It turns out that there is no biochemical reaction in any vertebrate on the planet. That requires dietary fructose. Now it happens to be sweet. It happens to signal our brain reward centres that we like the stuff we happen to crave it we happen to really enjoy it and a little too much, and in fact now we have data that shows that it just happens to be addictive as well
So the question about whether sugar can meet the criteria for an addiction or an abuse substance
Transcript generated on 2021-01-20.