Has Big Sugar become a public health menace?

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Dear Reader,

Corporate interests too often collide with public health. Think Big Tobacco (cigarettes and all sorts of diseases), Big Pharma (drug makers and opioid painkillers), Big Auto (car defects and fatal wrecks), and even the NFL (football and brain injuries).

Is it time that we add Big Sugar and its fizzy cousin Big Soda to this list of shame?

The question arises because conditions like obesity, diabetes, heart disease, and cancer remain stubborn killers despite decades of health awareness and wellness efforts. Why aren’t we bending the curve of survival in a better direction?

One not-so-sweet answer is emerging: Big Sugar and Big Soda may be pursuing their interests with such zeal that they’re undermining the public’s health, with both covert spending and big dollops of visible dollars to get consumers to guzzle record amounts of their unhealthy products. It may be time to just say no, not only for our own health but especially for our kids’ sake.

Evidence grows of sugar’s health harms

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It’s commonly seen as a refined white powder, which addicts zealously seek out and ingest no matter its harms. Ask most Americans and they might suspect this describes cocaine or heroin. But for tens of millions in the United States who never get anywhere near a dangerous narcotic, processed and refined sugar may be the substance of greater detriment.

Americans take in an average of 152 pounds annually of caloric sweeteners. Like addicts, we ingest sugar—as sucrose (table sugar), corn syrup, honey, maple syrup, and molasses—everywhere in our diet, sometimes without knowing it. Sugar, the No. 1 food additive, is sprinkled into pizza, bread, hot dogs, boxed rice, soup, crackers, spaghetti sauce, lunch meat, canned vegetables, fruit drinks, flavored yogurt, ketchup, salad dressing, mayonnaise, and some peanut butter.

Sodas? They add up to as much of a fifth of the refined sugar Americans take in. Boys take in more calories from sugar than girls do, with children and teens consuming 16 percent of their total caloric intake from added sugar. Black men and women consume more calories from added sugars than do whites, and the poor take in more than the wealthier. For American adults on average, 13 percent of their caloric intake comes from added sugar.

Uncle Sam issued an urgent warning this year that “Americans are eating and drinking too much [in] added sugars, which can lead to health problems such as weight gain and obesity, type 2 diabetes, and heart disease.”

Calling it “the fight of our lives,” the Harvard School of Public Healthhas pledged to help persuade Americans to slash consumption of salt and sugar, with experts at the respected institution noting that their “prime target is sugar in sodas, fruit juices, and other cloying drinks … [because] downing just one 12-ounce can of a typical sweetened beverage daily can add 15 pounds [of sugar to the diet] in a year. In children, one sweetened beverage a day fuels a 60 percent increase in the risk of obesity—and American teenaged boys drink almost three times that much.” The Harvard experts say that one of their studies linked sugary drinks to increased risk of heart disease in adults, not just because of the reduction the substance can cause in “good” HDL cholesterol nor just due to weight gain from increased calorie intake. They said sugar itself posed risks. Another Harvard study in 2004, the experts added, found that women who had one or more servings a day of a sugar-sweetened soft drink or fruit punch were “nearly twice as likely to develop type 2 diabetes as those who rarely imbibed these beverages.”

Both the American Heart Association and the American Cancer Society decry excess sugar consumption and its role in fueling obesity, which contributes to both cardiac diseases and cancers. The American Diabetes Association, while busting the myth that sugar directly causes diabetes, also warns about the substance’s contribution to weight control problems that worsen the disease. The association urges Americans to curtail their sugar intake.

One of the harshest sugar critics is Robert Lustig, a pediatrician and endocrinologist at the respected University of California San Francisco medical school, where researchers have focused on how sweets contribute to metabolic disorders in kids. These harmful conditions and others, Lustig and other researchers say, reverse—sometimes speedily—when youngsters cut out sodas, sweet cereals, desserts, and other high-sugar foods and drinks in their diets. The kids get healthier, not only undoing these chronic, damaging conditions but losing weight and feeling better, too, researchers say. Based on his work with children, as well as extensive and growing research linking it with many other harms, Lustig has labeled sugar and the myriad forms in which it seeps into Americans’ diet as a toxin or poison. He has offered his harsh views in much-watched YouTube videos and popular Ted Talks, and he and colleagues run a well-read blog called Sugar Science: the unsweetened truth.

Have Big Sugar, Big Soda taken a page from Big Tobacco’s ugly playbook?

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If sugar and sodas pose such health risks, why isn’t this information more widely known─and why aren’t the warnings spelled out in starker detail?

Just to provide perspective, the controversy over sugar has run for some time (including just a few years ago federal efforts to crack down on sugary breakfast foods and their makers’ targeting of kids). But so, too, have arguments over the health harms of smoking, cars, head trauma, and prescription painkillers. Americans started smoking tobacco almost from the time they arrived in the New World. But it wasn’t until the 1960s and 1970s that medical scientists fought back against a ferocious, well-funded misinformation campaign by Big Tobacco and got the federal government to regulate cigarettes and other tobacco products. Ralph Nader  was a second-year Harvard Law student in 1957 when he began amassing information on flawed cars that then killed tens of thousands of Americans each year. It was not until the mid-1960s that he persuaded a publisher to issue, “Unsafe at Any Speed,” and shortly thereafter Uncle Sam started forcing car makers—who attacked Nader and even had him followed by a private detective—to eliminate windshield glass that broke in lethal shards, pad dashboards and steering wheels, install seat belts (and make their use mandatory), improve auto bodies, and take other life-saving steps.

Dogged journalists now are dragging into light key information on how pro football is playing fast and loose with experts and medical research to prevent athletes from learning how bad head injuries related to the game can be. Investigative reporters are doing outstanding digging on Big Pharma’s insidious role in flooding the market with deadly opioid painkillers.

Big Sugar and Big Soda, similarly, have had their dubious practices exposed in research and news reports that raise serious concerns about big corporate money corrupting critical information about public health.

Experts, for example, were floored this fall when the peer-reviewed, prominent Journal of the American Medical Association published historical research that found Big Sugar had funded and meddled with important studies in the 1960s, downplaying sugar’s health harms and instead pointing at fats as culprits in obesity and heart disease. By today’s standards, it would be utterly unacceptable for  leading nutritional experts at Harvard (now dead) to have taken the tens of thousands of dollars, as they did from representatives of a sugar industry group, and to allow them to review and make suggestions on draft reports.  Experts say this unsavory conduct by Big Sugar swayed critical thinking in negative ways about nutrition and heart disease for a half century. It “derailed” vital discussions about the role of sugar, in its various forms, in many serious health conditions.

The revelations about Big Sugar’s forays into medical science followed an international controversy over Big Soda’s creation of the Global Balance Energy Network. Funded by Coke, the planet’s largest provider of sugary beverages, the network sought to team influential scientists, medical journals, social media, and major events—all to advance the notion that health approaches now over-emphasize calories instead of “more important” exercise. Critics said Coke was spending millions of dollars to promote an elaborate deception to get the public to lose sight of the empty calories in soda, with the unfounded idea that more exercise alone could lead to weight loss. Which it doesn’t. Journalists and opponents of Coke’s nutrition and exercise initiative pointed out the conflicts of interest, and said Big Soda’s approaches were harmfully reminiscent of tactics once used by Big Tobacco. The group, under fire, disbanded.

In recent days, Coke and Pepsi have been called out in the peer-reviewed  American Journal of Preventive Medicine for their “pervasive sponsorship of national health and medical organizations,” giving millions of dollars that has had a “nefarious” effect on public health. Researchers found that marketing initiatives boosted Big Soda’s reputation, and put almost 100 organizations too often on the side of industry in opposing legislation to cut consumption of sugary drinks—a goal that organizations like the American Cancer Association, the American Medical Association, and Harvard medical school typically would support as beneficial. The study not only names and shames the groups, it also lists 29 policy disputes, and how the organizations threw themselves on the industry’s side and against public health interests between 2011 and 2015.

Meantime, news organizations have detailed how candy companies surreptitiously have tried to shape nutrition research, funding studies at public universities. I’ve written about the small signs, detected by a savvy pediatrician in Latin America, that Big Soda is sneaking its product campaigning into medical practices outside of the United States, notably by targeting swag at Argentinian physicians and their young patients. But at the same time, tens of millions of dollars have poured into campaigns across the United States (see below) as Big Soda seeks to take the fizz out of local ballot initiatives that would impose taxes on sugar and soft drinks to try to discourage consumers, especially parents and kids, from drinking more pop. If successful, could elections and regulations be the start of America losing its harmful sweet tooth?

The battle against harmful sugar

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Soda taxes exist in Mexico, Berkeley, Calif., and Philadelphia. Proponents hope to add them in San Francisco, and the nearby California cities of Oakland and Albany, as well as in Boulder, Colo. Momentum, advocates say, is building to fight back against Big Soda by imposing new taxes on sugary soft drinks. Voters will decide the issue on Election Day.

Experts estimate that since Berkeley successfully imposed soda taxes, the industry, including the American Beverage Association, has spent as much as $37.7 million a year to battle similar ballot measures with campaigns and lobbying. But those allocations, in turn, provoked wealthy philanthropists, including Michael Bloomberg, the media mogul and former New York City mayor, and onetime hedge funder John Arnold and his wife, Laura—who all have targeted sugary soft drinks as public health menaces—to significantly increase their donations to almost $12 million to support soda taxes.

The research is still under way. But there are indications that adding even small obstacles (low taxes) to the cost of buying sodas cut their consumption, especially among the poor, who also may be a group that suffers extra harm from diabetes and heart conditions. Further, taxes and ballot measures help to spread  information about  the detriments of sugar and soda consumption, and that may be fueling significant declines already in pop drinking. That, in turn, has led to drops in sugar consumption and calorie intake. These all could benefit health.

Looking at Big Soda also may offer clues about Big Sugar and how corporate interests morph. Sugar remains a giant American business, producing billions of dollars in revenues, and employing tens of thousands. The industry will keep spending tens of millions of dollars in the public sector to influence policy, and many more dollars will go to marketing and advertising a myriad of products steeped in sugar. The industry long has targeted kids. But even as the tide seems to be turning against a key player like Big Soda, its leaders are moving the business in new ways, for example, by pushing products with alternative sweeteners, smaller package sizing, and relentless advertising and marketing (it was hard to miss Coke’s Super Bowl hype for its new soda in a different, green-colored can). If sweet carbonated drinks are tending to become passé, makers will flog flavored waters and sports drinks instead. I’ve written about how makers promoted sports drinks heavily during a steamy August when many fans, especially young athletes, were obsessed with watching the 2016 Summer Olympic Games. Pepsi, in a return to its pharmaceutical roots, is working with medical experts to use its expertise to improve the bad taste of tuberculosis-fighting drugs.  Look up and down at the aisles of the local grocery and there are other signs about how Big Sugar and its allies will push on: a public interest group hired an investigative reporter to detail how grocers assign and charge for prime spots (such as near the check-out register) to sell unhealthful foods, especially sweets. Even the venerable and highly successful Ronald McDonald, the icon of a fast-food chain that has a long history and huge role in selling sugary products (especially Cokeand sweet desserts), is getting a make-over. He and his company are striving to stay with the times by promoting more healthy foods and eating.

American consumers themselves may need to take more control of their health by slashing their sugar intake. We’ll need to become more aware of where sugar crops up in our diet, and be less surprised where it does, including in foods described as healthy.We’ll need to recognize that foods we assume are good for us, including fruits and their juices, can be laden with sugars. Let’s drink lots of water instead of soda. We’ll get rid of the sugar bowl on the kitchen and dining room tables. We can avoid hidden sugars by staying away from highly processed and fast food. As grown-ups, we’ll have to step up even more our vigilance about what our kids eat, what messages they get about healthy foods, what they spend their money on, and which corporations may be targeting them. Big Sugar and Big Soda may have taken a page from their giant corporate predecessors like Big Tobacco, and, even if they appear to be seeking to reduce sugars in their products and voluntarily accepting oversight and regulation, they still need watching like a hawk.

It won’t be easy for any of us to curb our sugar consumption, reduce our calorie intake, and maintain healthy eating and weight. I’m not suggesting we ban an occasional doughnut or an ice cream treat. I’ve written that rather than moving to extremes in all these areas, moderation in diet and nutrition matters. May we all be healthier by following that course of not too much, not too little.


Evidence grows of sugar’s harms

Have Big Sugar, Big Soda taken a page from Big Tobacco’s ugly playbook?

The battle against harmful sugar

Sugars differ; does this affect health?

Are we better off with artificial sweeteners?



Pounds of caloric sweeteners that the average American consumes each year.


Teaspoons per day. That’s the maximum recommended sugar intake for someone consuming 2,000 calories per day. Most adults  take in almost double that, around 22 teaspoons daily.


Number of national health organizations that accepted millions of dollars in Big Soda sponsorships between 2005 and 2011.

1 in 3

Number of Americans considered to be obese,a condition that harms their health and has been linked in part to excess consumption of sugars.

Sugars differ; does this affect health?

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When it comes to people, refinement matters. That also applies to sugars, some researchers say. There are different kinds, depending on their source. There’s some debate whether some types are better or worse for us than others.

Substances that end in -ose are sugars: sucrose, fructose, maltose, and dextrose are all sugars. They may be derived from cane, beets, fruits, and grains. Lactose, another sugar, occurs in milk and dairy prodcuts.

Medical scientists in San Francisco have published research indicating that the highly refined sugar from fructose, typically a fruit-derived sugar, can be highly damaging to our health. That’s because, they say, it is processed in the liver like alcohol. Besides the other harms it causes (adding calories), heavy consumption of fructose can lead to liver problems.

Then, there’s high-fructose corn syrup (HFCS), which has become almost a dirty word among the dietary gurus. They point out the huge rise in obesity in the United States occurred about the same time that Big Food makers began pouring cheap, plentiful HFCS into processed foods that became staples of the American diet. A 2010 Princeton University study that tied the substance to abnormal weight gains in ratshas led even fast-food franchises to try to rid their products of HFCS.

In recent years fads have come and gone about the alleged “benefits” of switching to sugars from coconuts or agave or what have you. The bottom line’s the same: Sugars from whatever source add calories that can contribute to weight issues that create myriad health woes. Americans consume way too much sugar. And, as with any substance, excess isn’t good.

Are we better off with artificial sweeteners?

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Many Americans think they can sidestep sugar woes with better living through chemistry,  switching to “diet,” low- or no-calorie products with manufactured sweetness that removes the calories.

The federal Food and Drug Administration acts as the watchdog over the safety of artificial sweeteners, and it provides lots of information about the various kinds. The agency describes the most common varieties, based on sometimes extensive research, as GRAS: generally regarded as safe. But the feds candidly discuss, for example, a 1970s scare over saccharinand its potential links to bladder cancer.

For soda addicts, especially, there’s not consensus good news about advantages in guzzling “diet” drinks instead of regular varieties. It doesn’t appear to help cut calorie intake and weight loss. Why? People consume too many diet sodas, thinking the beverages are calorie free. They aren’t, and drinkers shouldn’t feel entitled to splurge, including with other treats because they “saved” calories. Those diet sodas also may be bad, because they adversely affect the gut biome, and they may contribute to metabolic syndrome, type 2 diabetes, and heart disease.

Here’s a critical issue that artificial products fail to address: Why do some of us crave sweets so frequently and intensely? That’s not an easily answered question, as food can trigger such a rangeof human responses. Dieters know painfully well that healthy habits are hard to create and keep — that includes controlling our intake of sweets. But the research can’t be ignored: Intake of sweets matters even if they’re sweetened from new molecules and not the traditional sugars.

Photo Credit: Flickr Creative Commons, Sharon & Nikki McCutcheon



Patrick Malone
Patrick Malone & Associates