Drugs, Cigarettes, Alcohol… and Sugar?

Here’s the seventh and last part of the great “Skinny on Obesity”-series, featuring dr Robert Lustig.

He makes the case that sugar should be regulated by the government, using taxes and limiting the availability, inspired by the way we already regulate cigarettes or alcohol. I know that government regulation is a controversial subject, especially in the US. But I think dr Lustig’s arguments are strong. The obesity epidemic is already an emergency. Not acting decisively will likely have bad consequences for us all.

Unfortunately this will be a long struggle against the sugar and fast food industry, similar to the one against Big Tobacco. It may be even harder as there’s even more money in food than in cigarettes. But the fight will have to be won. The alternative is just not acceptable.

More about the free updates that people get.

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Can You Prevent Childhood Obesity with a Lot of Carbohydrates? 17
LCHF-Success Greetings from India 47
All Diets are Equally Good … Or Are They? 72
Fruit is candy 154
Give Julian Bakery what they Deserve 60
New Study: Is Today’s Wheat Bad for You? 56
Even Tour de France Cyclists Avoid Carbs to Stay Lean 111
Historic 73
Stunning: Saturated Fat and the European Paradox 168
Lose Weight by Cutting Down on Dairy Products and Nuts 102
Is this the Healthy Mediterranean Diet? 21
Sugar: Hiding in Plain Sight 47
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33 Comments

  1. osteoDH
    Thumbs up for Dr Lustig!!!
    Now let's focus on the addictive brain ( endorphin-serotonin) part
  2. Alexandra M
    I think the success of the anti-smoking campaign was due more to the propaganda that caused smoking to become "moralized" than to taxes and regulations. In spite of the fact that a pack of cigarettes in NYC now costs $11, you don't see well-off people smoking, only poor people.

    "Rozin notes, for example, that smoking has lately been moralized. Until recently, it was understood that some people didn’t enjoy smoking or avoided it because it was hazardous to their health. But with the discovery of the harmful effects of secondhand smoke, smoking is now treated as immoral. Smokers are ostracized; images of people smoking are censored; and entities touched by smoke are felt to be contaminated (so hotels have not only nonsmoking rooms but nonsmoking floors). The desire for retribution has been visited on tobacco companies, who have been slapped with staggering “punitive damages.” *

    I wonder if we'll ever see punitive damages slapped on General Mills?

    Also, the government doesn't "regulate" recreational drugs, it bans them - or tries to, with the same negative outcomes we saw with Prohibition.

    The annoying banner ad on the video was for bread!

    * http://www.nytimes.com/2008/01/13/magazine/13Psychology-t.html

  3. Peggy Holloway
    But even Lustig doesn't seem to get that carbohydrates = sugar, and just regulating "sugar" won't solve the problem of excessive carbohydrate consumption in the form of "healthywholegrains" and "eat lots of fruits and vegetables" (without a qualifier for low-sugar fruits and non-starchy vegetables).
  4. Ondrej
    Hello,
    I am a medical student. I'd like to ask You what is the best english book on basically LCHF, rather in terms of explanation, kind of professional, for medical student who can pass the knowledge to his friends and family. I know Mark Sisson's Primal Blueprint is easily accessible etc, but what is the best book on the other side of the spectrum, the one with latest data and best explanation? New Atkins for new you? Cordain's Paleo Diet? Good Calories, bad calories? Or Your book? Will there be an english version?:-) Thanks for answer.
  5. Government regulation of diet is something to be avoided at all costs. That is because politicians and bureaucrats know less than nothing about diet, and will get it wrong every time. A good example of that is the new Fat Tax of one of your close neighboring countries.

    @Ondrej: Check out The Ketogenic Diet http://sn.im/ketodiet by Lyle McDonald. It's somewhat dated, but has good explanations of the mechanisms involved. It's also a self-published work (part of Lyle's PhD), and the presentation is not particularly "polished."

  6. Yoly Erva
    Lustig seem to be more in tune with the old now free PDF book “THE SACCHARINE DISEASE" by T. L. CLEAVE, M.R.C.P. than with LC or Paleo.

    http://www.cybernaut.com.au/optimal_nutrition/information/library/sac...

  7. Richard
    Ondrej, I think the best and most up-to-date book for an educated layperson or a scientist would be "The Art and Science of Low Carbohydrate Living" (2011) by Drs Volek and Phinney - Highly recommended!
  8. Alexandra M
    Did you notice how that woman talking about sweetened beverages emphasized that fruit juices sweetened with added sugar were bad, leaving a BIG loophole for fruit juices with "no added sugar?" Because everyone knows that the best way to start the day is with a giant glass of orange juice! "No added sugar," of course, just healthy and natural fructose. :(
  9. I remember when it seemed like nearly everyone smoked--you could even smoke in college classrooms if the professor smoked--then as the seventies rolled on, there were all these magazine and newspaper stories about the dangers of cigarettes, and the accompanying diatribes about "freedom" and so on at which we in the US are so adept. Then as time passed, more and more people quit smoking, no more cigarette ads on TV or in print media, much higher taxes on cigarettes; a further move to protect children from cigarette ads with cartoon characters meant to entice them. Then trials to try to prove that cigarettes did cause cancer--the tobacco industry had doctors and scientist claiming there was no way to prove tobacco caused cancer, etc. Sound familiar? I see the exact same process at work with sugar-starch-artificial sweeteners-highly refined foods.
    Once the door is opened a crack, information will eventually begin to flood through. Thanks to people like Dr. Atkins, Gary Taubes, Jimmy Moore, Dr. E, and the growing list of professionals who are no longer afraid to tell the truth--and those of us who find out the hard way that food/a way of eating is like religion to many people, so we don't expect others to convert just because we see the light, but keep on the path regardless.

    All hail the freedom of information to flow unhindered!

  10. Janknitz
    I agree with Howard. It's a terrifying idea to allow the US government to apply sin taxes to food because they get it SO wrong.

    Right now, today, the government could easily tax fat since most people believe that's the greatest source of evil in our diets. And the net result of a stupid move like that would be to drive people to even more fat free but carbohydrate rich manufactured products masquarading as food. A true national tragedy.

    If the government can't understand basic biochemistry, despite all their "experts", what chance do the American people have. And truly, the tobacco industry is just a drop in the bucket compared to how tightly intertwined grain based agriculture is to the very fabric of the US economy. If it doesn't come from the people themselves, I see no way that it's going to happen.

  11. Sarah
    I would prefer that our government stay far, far away from any further attempts to "help" us unless that involves ending all farm subsidies and getting out of the business of handing out nutritional advice.
  12. Chuck Currie
    We need to raise the risk to growing wheat, corn and soy by removing subsidies and crop insurance. This will raise the price of these commodities without directly taxing them - what we pay for an item effects all those involved in producing and delivering that item; taxes go straight down a black hole.

    This will not only raise the price on processed package goods - reducing their consumption - it will also raise the cost of Concentrated Animal Feed Operations (CAFO) bringing the price of industrial beef into competition with grass fed beef (not as high, but higher). Some farmers will become ranchers, converting crop acreage to grass lands for raising beef, further reducing the price of grass fed beef.

    Converting wheat, corn and soy acreage to grass land will further raise the price of processed packaged foods, making whole foods (fruits and vegetables) relatively less expensive.

    We also need to reduce/eliminate government regulations on small/family farms to increase competition and enable a more open and free market ag economy. Go and read the Polly Face Farm blog if you want to get any idea of the nightmare government regulations create for small independent farmers. I.E. You cannot sponsor a school field trip to your farm, because education is not a farming activity!

    Next, the government needs to remove all tariffs and protections from the sugar industry. Yes, this will reduce the price of sugar as more competition enters our market. But, it also increases competition with high-fructose corn syrup, making it less desirable. Trading sugar for corn syrup is a good start.

    A personal aside - my wife has an intolerance towards corn, and therefore, corn syrup. She also loves to drink and Coke with heave whipping cream mixed in (think Coke float after the ice cream melts). Because of her corn syrup intolerance, she drinks Diet Coke, full of Aspartame. I would gladly exchange sugar for her Aspartame any day. Occasionally, we can get Mexican Coke, which is made with sugar.

    Government taxation and regulation distort markets - and, never in a good way. And those who think it would be abominable for the government to regulate and/or tax sugar; just think about the dairy industry, where it is illegal to sell milk straight from a cow's teat, they way nature intended for it to be consumed (if your OK with dairy), and you will realize that the government can do whatever it damn well pleases when it comes to food.

    When it comes to personal responsibility (which Dr. Lustig spoke to), our healthcare system, for the most part, has eliminated, or reduced, it becomes unnecessary when it comes to what you put in your mouth, suck into your lungs, or shoot in your veins. Unless you are paying for all your own healthcare directly out of your pocket, why should you care? Get sick, see the Doc, get a pill, symptoms reduced or eliminated, and you're on your way. Easy, peasy and Bob's your uncle. And when Obamacare morphs into single-payer, socialized medicine - all incentives for personal responsibility vanish.

    There is nature (or God, if you prefer) made food and there is man made food. One is good for you and the other, with few exceptions (I'm thinking Kerrygold butter) is crap, and will make the last 25 years of your life miserable.

    Seeing how NONE of this will happen in my life time - it's up to us and the wonderful freedom (so far) of the internet, to turn this tide around.

  13. Chuck Currie
    What a moron - I reported my own comment as improper! Twitchy finger. LOL
  14. AnotherRachel
    What is the evidence that public healthcare turns reasonable people into risk taking fools overnight?

    I am a Brit, I have a free healthcare service, and I REALLY give a damn about what goes in my mouth. Sugar and wheat make me feel bad, and cause symptoms I don't want or need to have, or need to bother the doctor with. So I don't eat sugar or wheat. Sounds like personal responsibility to me. Meanwhile the US has private healthcare and an obesity epidemic. I'm sorry, I don't buy the political posturing. Agree with everything else you say.

  15. Brigitta
    Why not educate children in school about the dangers of excessive sugar/starch consumption like they do with other drugs in school? Because the USDA wouldn't have any of that.

    If kids aren't taught this from a young age, it will be near impossible to reach them as adults. Look at how many of us over the age of 18 buy into low-carb and "the rest" of the general public. Most adults are too busy to listen.

    Taxing foods is not the answer. It goes deeper than that and this issue needs to be hit harder than just simply making people pay more.

  16. Chuck Currie
    No political posture intended - observational only. And you are mistaken about U.S. healthcare. The vast majority of those with third party healthcare pay very little, if anything, for it. It is either paid for, or subsidized by their employer (which is a trade off of benefits for wages), or the government pays for or subsidizes it - Medicare, Medicaid, Veterans Health, etc. As a percentage, the number of people that pay directly for their health care, either through the purchase of insurance, or cash for services, is very small. And those without access to any private insurance or government plan, can walk into any hospital emergency room and get care equal to those who pay - its the law - and if they can't pay, the hospital writes it off.

    I too, like you, receive all my healthcare for free - Veteran - and, I too care a great deal about my health and what goes in my mouth. I've had to provide care for members of my family who didn't care about their health, beyond complaining about how long they had to wait to see the doc, because it was no financial burden to them. They had employer/government paid healthcare their entire lives. But if they had had to pay every time they went to the doc and for every drug they had to take, believe me, their behavior would have been considerably different. These were hard working penny watchers.

    And the Brits are not immune to the obesity, lung cancer, heart disease, diabetes or alcohol and drug addiction. Take away the free meds and more people will start paying attention to what they eat, smoke, pop and inject.

    When there are no consequences for an action, there's no need for personal responsibility.

  17. Brad Midgley
    Did anyone else see the HFCS lobby buying ad space on this video? In the video they are talking about how much money there is behind bad food as the ad blinks right in front of them!

    Dr Lustig should call these guys out IN THE VIDEO. Tell people to think critically about the ads that surround the video you are watching RIGHT NOW. :)

  18. Steve
    No sugar should not be added to the list of things our big brother nanny state regulates. Here's a simple idea, how about our big brother nanny state simply tells the truth about what is, and what is not healthy? Ridiculous, I know!

    The issue isn't that we need to have our hands held, its that we have in fact followed the directions of our misinformed leadershipless leaders!

  19. Will
    i would focus on public education. ending subsidies for crap food. however, banning and taxing is something i don't support. if somebody wants to kill themselves by overdosing on sugar please let them. by the way any kind of sugar ban/tax is just not going to happen in any case. the food companies own the government... so good luck pushing for it...
  20. Brigitta
    @Will I completely agree. It's stupid to tax because that's not going to stop people from consuming something. Besides, when in history has stopping someone from doing something actually prevented anything? Usually it makes the problem worse.
  21. Alvaro
    Please stop getting the government involved in people's choices and pockets. Even when it works, it is at the cost of liberty and personal responsability.
  22. Alvaro
    @Will - absolutely agree. Stopping subsidies to corn producers would be a good start.
  23. Alexandra M
    "And those without access to any private insurance or government plan, can walk into any hospital emergency room and get care equal to those who pay - its the law - and if they can't pay, the hospital writes it off."

    What a load of crap. People without insurance don't walk into the emergency room with an infected ingrown toenail before it becomes a gangrenous, life-threatening emergency - a much more expensive emergency. Nobody wants to be sick. It's not like putting off an oil change until the engine seizes up. Sickness hurts.

    And hospitals do NOT "write it off" - not before harassing people with debt collection agencies and threats. If you've ever looked at the "indigent fund" requirements for hospitals, the only way you can qualify is if you are way below the REAL poverty line. They say 250%, but that means if you make $25,000 per year, you are still liable for a $50,000 hospital bill.

    "The Wall Street Journal on Friday examined actions taken by students at Yale Law School's legal clinic on behalf of patients who have "tangled" with Yale-New Haven Hospital's "aggressive debt-collection tactics." The hospital, the teaching facility for Yale's School of Medicine, "has been one of the prime focuses of a national outcry over hospital billing practices," the Journal reports (Lagnado, Wall Street Journal, 11/14). The Journal previously had reported on the case of Quinton White, an uninsured man struggling to pay about $40,000 in medical bills that accumulated from his now-deceased wife's cancer treatments. After the Journal's report, the hospital agreed to forgive White's debt and to investigate other cases of debt collection (Kaiser Daily Health Policy Report, 4/1). However, the hospital's recent actions have not prevented the law students from seeking further action and threatening to file a class-action lawsuit against the facility, contending that it "failed to inform low-income patients" about the availability of a "free bed" fund at Yale-New Haven. That fund is made up of a pool of money donated to help indigent patients receive medical care; internal guidelines and state statutes say that people with annual incomes up to 250% of the federal poverty level can apply for assistance through the fund. The Journal reports that the fund had a value of about $37 million in 2001, but that figure decreased to about $24 million because of market declines. "

    But the whole "healthcare causes bad choices" argument is crap because the people making the worst choices right now are the people who don't have health insurance.

    It's like arguing that people will smoke in bed more if there's a fire department.

    And I was totally cheering reading the parts of your post about ending farm subsidies because I believe the same thing.

  24. Chuck Currie
    "But the whole "healthcare causes bad choices" argument is crap because the people making the worst choices right now are the people who don't have health insurance."

    Now that is an absolute statement that is an absolute fantasy. Look at that video again, and then tell me that ALL those obese people are uninsured.

    There are all kinds of bad choices one can make. Some of them will kill you instantly; some will kill you very slowly and insidiously. That's why there are fewer BASE jumpers than there are obese people.

    People who are obese, and suffer all the consequences, didn't chose to be obese necessarily, but, they also didn't make the responsible choice that those reading this blog have made by finding out why they are obese, and sick (or how not to get that way) and then doing something about it. And, part of that reason is because they have access to inexpensive healthcare that provides them, not with a cure, but a placebo that makes them feel better.

    You contradicted your own statement on hospitals not writing off unpaid bills. Then you quote an article that describes a charitable fund with $24 million for the less than indigent. And, everyone has the access and the ability to avail themselves of bankruptcy protection.

    Also, I didn't say paying for healthcare was easy or painless - I said healthcare was available to everyone who seeks it regardless of financial status. And I'll bet you dollars to donuts that Mr. White spent a lot more than $40k on stuff he really didn't need to survive and not one dime on medical insurance before his wife became ill. People have choices and they'll choose a car and 40" flat panel TV before medical insurance, and that's because no one believes that "it" will happen to them, whatever "it" is, and they figure someone will pick up the tab if they can't.

    We may have to agree to disagree on the issue of our current healthcare delivery system(s), its availability and the distortions it causes in the market and how people respond to those distortions.

    One more point on healthcare: Actual "healthcare", at any price, is not what we have; what we have is "sickcare". 99% of docs will not stray outside of Standard Practices and Procedures for fear of being ostracized by their colleagues and boards, or sued. And, yes, Dr. Eenfeldt is the exception that proves the rule. I suffered from GERD for nearly 15 years, and took PPIs daily for 7 of those years, and not once did any of the docs I say tell me to stop eating wheat. I found that little gem on the internet. (Thank you Mark Sisson)

    No consequence = no risk = no responsibility. This applies, not only to people in general, but to the medical industry especially. Docs see no risk in following the SPPs because there are no consequences, therefore they take no responsibility for the patients outcome. You die, you die, sorry, but I followed the instructions, so it's not my fault. You owe me $40k.

    Ok folks, hit me with your best shot.

  25. Ondrej
    I live in the Czech Republic. It's very hard for me to pick healthy choices. Grass-fed beef in the supermarket? Fresh fruit or vegetables? Bio eggs? Fat yoghurts? Alaskan wild salmon? None of these products are easily available, you have to go to special, rare places or do some internet shopping to get them. And the list could continue forever. Everything is of the worst quality, supermarkets even refuse to sell products that aren't enough sh..cheap. This is a problem. It should be easier to eat healthier when you decide to and that's the area where government should step up their game.
  26. Alexandra M
    "People who are obese, and suffer all the consequences, didn't chose to be obese necessarily, but, they also didn't make the responsible choice that those reading this blog have made by finding out why they are obese, and sick (or how not to get that way) and then doing something about it."

    Except that there are plenty of people, health conscious people, who would say that YOU are not making "the responsible choice" because you're reading the blogs of "fringe diet gurus" instead of trusting your family doctor. The idea that eating fat - animal fat! - is okay is still considered a dangerous heresy by most of the medical community. To the majority of the population, LCHF is out there with coffee enemas to treat cancer. How can ordinary people know whom to trust? "Well, they could read the peer-reviewed literature themselves." But when even other scientists reject that literature, why would a non-scientist be expected to trust it? People who aren't experts in a field can reasonably be expected to make their choices based on the advice of people who are widely recognized experts in the field. So most people looking for advice on what to eat and how to lose weight are going to see advice on hundreds of blogs all claiming different things, all claiming to make sense, and they're also going to see advice from Walter Willet of The HARVARD School of Public Health. The "smart" money will plump (!) for Willet and Harvard.

    The point of the article was to draw attention to the fact that even though YNH has the fund, they go to great lengths not to disburse it.

    "I said healthcare was available to everyone who seeks it regardless of financial status."

    Really? How does that work?

    "And I'll bet you dollars to donuts that Mr. White spent a lot more than $40k on stuff he really didn't need to survive and not one dime on medical insurance before his wife became ill. People have choices and they'll choose a car and 40" flat panel TV before medical insurance, and that's because no one believes that "it" will happen to them, whatever "it" is, and they figure someone will pick up the tab if they can't."

    How could you possibly know that? How do you know he didn't get laid off from his job and lose his insurance? This is so full of stereotypes of poor people as somehow morally inferior. Have you ever met any actual poor people? Sometimes that car isn't a "choice" because they need it to get to work where there is no public transportation.

    "And, everyone has the access and the ability to avail themselves of bankruptcy protection."

    "Are there no prisons?...And the union workhouses - are they still in operation?...I help to support the establishments I have named; those who are badly off must go there."

  27. Chuck Currie
    Good Morning LCHFers!

    "Except that there are plenty of people, health conscious people, who would say that YOU are not making "the responsible choice" because you're reading the blogs of "fringe diet gurus" instead of trusting your family doctor."

    You're absolutely correct. But, after 4+ years, my results and their family doctors advise speak for themselves. The skeptics are starting to come around (my daughter and her husband finally gave up feeling like crap last week and dove headfirst into paleo. After less than a week, my son-in-law says he hasn't felt this good ever [he's prone to exaggeration] and so orally satisfied. Ha).

    Have I ever known anyone who was poor? I guess that depends on how you define poor. Do I personally know anyone who lives in the garbage/trash dump outside Manila? No. Do I know anyone who lives on minimum wage and has a smart phone and internet access? Yes.

    Smart ass aside, my first child (the new paleo convert who turns 30 this year) was a Medicaid baby and we were on AFDC. So I guess the answer would be yes.

    " "I said healthcare was available to everyone who seeks it regardless of financial status."

    Really? How does that work?"

    About three years ago, a family member was unemployed without unemployment benefits, bank account depleted and no medical insurance. They were living with other family members, so they had a bed and food on the table.

    Then they had to have an operation. Well, through a combination of a Catholic non-profit clinic (this person is not Catholic) and a county medical program for the poor, they got the operation, 4 days in the hospital and follow-up care and it cost them nothing.

    Betting is not knowing - that's why it's called gambling.

    Bankruptcy is neither a prison or union workhouse, it's a financial condition. Our laws provide a legal means to discharge your debts without going to prison, poorhouse or workhouse. That's why it's called Bankruptcy Protection. Just ask Donald Trump.

    Well, my 93 year old paleo mother is in need of groceries, so I'm off. Adieu

  28. Heather
    Our government has a very poor track record!
    It is still pushing Low fat, Low calories!
    I am starting think the wheat, sugar and processed food producers are the government.
    If the government really cared about the people it would ban HFCS right now.
    Why tax people unless you want their money.
    I say it is all up to you!
  29. NS
    Hey Chucky,

    Please post your nonsensical, fanatical ideologies elsewhere. This is a health blog. Nobody is helped by your loony anti-government, free-market-fundamentalism drivel here.

  30. Álvaro
    Chucky, keep posting here. And pro-government anti-free-market-fundamentalist drivelers too.
  31. John Myers
    If the long-term cost of an item is not reflected in its price then it's not a free market. The long term cost of pop, or soda beverages, or Coke - whatever you want to call it is enormous.
    If you want a lawless anything goes free market then you're hoping for a world that nobody would ever want to live in: a world of unfettered snake oil salesman and hucksters.
    Democratic governments can compensate for unreflected costs and use taxation (a blunt tool) to do it.
  32. Tresa Rivers
    I don't think the government should regulate sugar - or tobacco or alcohol. I believe in personal liberty and responsibility.

    However, in the USA I do think we need to stop SUBSIDIZING corn, and by proxy HFCS.

  33. Chuck Currie
    OMG!!! Statist Beware!!! More "Free Market Drivel" Quick click away, click away don't succumb to this blasphemy.

    Tresa needs to shut-up and go away! Only approved speech allowed on this blog.

    LOL HAHAHAHAHAHaaaaaaaaaaaaa

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