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Sugar in food is poorly labeled, and the industry likes it that way

Without clear labels on sugar and public education, 'personal responsibility' is a non sequitur

A wild animal is never more dangerous than when it is cornered. And Big Sugar is lashing out with all the sweet venom it can muster in response to the latest attacks on the iniquities of the American diet. These attacks are now seemingly coming from all directions.

Scientists have now demonstrated not just correlation, but causation for sugar and diabetes, fatty liver disease, heart disease and tooth decay. Investment banks Credit Suisse and Morgan Stanley have weighed in on the effects of the detriments of excess sugar consumption on healthcare costs, economic productivity and the global economy. The Indian government has asked PepsiCo to reformulate its flagship beverage to reduce the burden of diabetes that country is facing. And the passage of the Mexico and Berkeley soda taxes have pierced the armor of the once-impenetrable Big Sugar.  

So, why pick on sugar? The industry says, "a calorie is a calorie, and a sugar is a sugar." In her Opinion L.A. blog post raising questions over a proposed federal requirement to label "added sugar," Karin Klein cites nutritionists who say that processed grains like white flour "have pretty much the same nutritional profile as sugar."

But it's not true. Sugar starts to fry your liver at about 35 pounds per year, just like alcohol would at the same dosage. This is because fructose — the sweet molecule of sugar — is metabolized in the liver just like alcohol. It's not because of the calories. Alcohol is not dangerous because it has calories; alcohol is dangerous because it's alcohol. It's the same with sugar. And we're at 100 pounds per year, triple our limit. That is why children now get the diseases of alcohol consumption — type 2 diabetes and fatty liver disease — without ever drinking alcohol.

Two regulatory issues are currently in play. As Klein notes, the U.S. Food and Drug Administration must now decide on the proposal for including "added sugar" on the Nutrition Facts label, and the U.S. Department of Agriculture must act on its own Dietary Guidelines Advisory Committee's (DGAC) recommendation to limit added sugar consumption to 10% of total calories. The food industry is fighting both of these tooth and nail.

The success of the FDA proposal rests on the ability of the new label to educate the public about what the industry added to the food. The industry says that the Nutrition Labeling and Education Act of 1990 requires only the disclosure of total sugars, which includes the strawberries in your strawberry ice cream, the lactose in the milk (neither of which is a problem) and the added sugar. But how much of that total sugar is lactose, and how much is added sugar?

Consider a 6-ounce carton of pomegranate yogurt, which has 19 grams of sugar. A plain yogurt has 7 grams of sugar, all lactose (milk sugar), which is not a problem. Thus, each pomegranate yogurt has 12 grams of added sugar. Plus, the industry hides the sugar well. There are 56 different names for sugar; by choosing different sugars as the fifth, sixth, seventh and eighth ingredients, sugar can rapidly add up to No. 1.

The industry’s response is something like this: "If we told the consumer how much sugar we added to any given product, our competitors could duplicate our recipes. This is proprietary information, and you can't know it." In other words, according to Big Sugar, it's not necessary for you to know. But it is. "Personal responsibility" is a non sequitur without public education. How can we expect anyone to make a rational decision when the information on which to make that decision is withheld?

Conversely, the DGAC recommendation to the USDA would limit added sugar to 10% of total calories, a far cry from the 25% that the Institute of Medicine sanctioned in 2004. As an example of the importance of this proposed new mandate, in 2011 the Environmental Working Group (EWG) identified 17 breakfast cereals marketed to children in which added sugar constituted more that 50% of calories. Despite the notoriety of that disclosure, the EWG follow-up in 2014 noted that none of these breakfast cereals had reduced its sugar content. If the DGAC's recommendation becomes government policy, then the Nutrition Facts label will show that that a typical bowl of breakfast cereal provides 33% of the daily value for added sugar for adults, and a 12-ounce can of soda provides 90%.

If added sugars should only be 10% of total calories, the industry’s claim would wash away. It would be forced to reformulate.

The goal of the food industry is to keep these two battles divided. Because if the FDA and USDA were to unite and combine these two policies, the disingenuous nature of the industry's practices will be obvious. For instance, the FDA has established a disqualifying level of certain nutrients for manufacturers making health claims. Previously they monitored total fat, saturated fat, sodium and cholesterol. This is an outdated list. The FDA and USDA need to provide a disqualifying level for added sugar. Walk down the cereal aisle and you will see candy-named products marketed to children (with appealing cartoon characters) that tout how healthy the cereal is. Really? And does anyone really want to attest to the health-promoting properties of a GoGurt?

There are 51 separate agencies in charge of our food supply. That suits the food industry just fine. Their strategy is to divide and conquer. It's time for us to unite to tame this wild animal before it can sicken another generation of children.  

Dr. Robert H. Lustig is a professor of pediatrics at UC San Francisco and the president of the Institute for Responsible Nutrition. He is the author of, among other books, "Fat Chance: The Bitter Truth About Sugar." He doesn't take industry money.

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