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Toxic Sugar Politics

Every morning I put about half a teaspoon of sugar in my coffee. Then I usually do that again. And I love it. That is the single use I have for the stuff, although it gets into my mouth and body via many other foods and drinks, as it's contained, and often hidden, in so many forms in other things it's virtually impossible to avoid. Even though I have always been a healthy eater, avoiding processed stuff wherever possible, I too likely get more than is good for me.

Dr. Sanjay Gupta of “60 Minutes” just did a segment titled “Sugar and Kids: The Toxic Truth.” Almost a year ago, the New York Times Magazine featured a cover story titled “Is Sugar Toxic?,” wherein University of California pediatrics professor Robert Lustig, featured in both these reports, basically answers with an emphatic, “yes.” But I've been a little reluctant to apply the term “toxic” to sugar, as that often seems to imply that a substance is unhealthy, even deadly, at any level — “the dose makes the poison' is the longstanding toxicological maxim. But that maxim is being challenged on a number of fronts, particularly regarding some industrial chemicals that can impact our health at much lower levels than previously suspected. Plus we now have to consider the time we are exposed — kids, even embryos, can be particularly vulnerable to some substances, even sugar, and have their metabolisms programmed towards unhealthy outcomes. But semantics should not be the issue here; if sugar, at levels it is being consumed by many kids and adults, is causing obesity, diabetes, and a host of other conditions, “toxic” might well apply. And thus, when Lustig and his colleagues recommend taxes, controlling access, and restrictions on sales of high sugar products in schools and workplaces, it increasingly makes sense. Think tobacco.

One thing is undeniable, though — the politics of sugar can be toxic. When San Francisco considered a penny tax on sodas — ie, sugar water — last year, a couple of reactions were predictable. First an outburst of mostly anonymous online comments in a frenzy reminiscent of a group of preschool children who had consumed too much sugar. Second came denunciations by the soda industry and at least one so-called “consumer” group funded by them. But among health professionals who have long lamented increasing obesity, diabetes, and heart disease in our communities, another reaction to the soda tax/fee proposal was more common: “Why has this idea taken so long to become reality?”

Ideologies aside, the rise in obesity among both American children and adults presents a looming health disaster, but also an economic one. As noted by the UCLA and California Center for Public Health Advocacy (CCPHA) researchers, $41 billion is spent treating obesity in our state annually. There are many reasons for increased obesity, but no denying that consumption of sugar plays a significant role, especially among young people.

At the same time the California study was released, a team of leading figures in food and nutrition published a paper titled “The Public Health and Economic Benefits of Taxing Sugar-Sweetened Beverages” in the New England Journal of Medicine. These physicians and other researchers, from Yale, Harvard, and elsewhere, produced a document that should be required reading for anybody interested in this topic — perhaps before they post comments online or send angry letters to newspapers.

The NEJM paper outlines “sugar science” most convincingly, but also provides an equally important outline of the financial side of the issue. As has now been learned from long experience with tobacco, taxing sodas can not only generate much-needed revenue for health services, but also discourage consumption. Although a majority of states already have a soda tax in some form, the NEJM authors propose a national tax of one cent per ounce, which would generate around $15 billion per year — $1.8 billion in California — and also lead to weight loss in soda drinkers. The revenue should be used for child nutrition and obesity education and treatment programs, they propose. Dental care might logically be thrown into the mix as well.

The proposal makes economic sense. We all pay, or will pay, ever-increasing amounts for the impacts of sugar over-consumption, via tax-funded healthcare, education, and other expenses. We even subsidize the production of sugar and its evil twin, high fructose corn syrup, to the tune of $3billion annually. Why not have the producers and consumers cover more of their fair share?

One sad answer is that such a tax might produce the desired effect of reduced consumption — and thus the appearance of new beverage-industry lobbying groups like “Americans Against Food Taxes” — something very similar to the now-defunct “Tobacco Institute.” So far, expensive lobbying has gutted tax of subsidy-reduction proposals from public budgetary or health reform proposals. And of course “no new taxes” is a Tea Party rallying cry (sugar in tea is good too). But look: Even Adam Smith, a founder of modern economics and free market theory, held that sugar is “an extremely proper subject of taxation.”

Leading nutrition expert Dr. Marion Nestle notes that our national sugar policy is “ripe for satire"; she also succinctly advises, “eat less sugar.” That goal, and rational taxation, will be long battles, but worthy ones. Recall that tobacco was once a subsidized product, and that half of Americans used it. Real progress has been made in reducing that percentage to less than half of what it was a couple generations back — albeit with still much work to be done there.

The San Francisco sugar tax proposal, and those in other cities and states, have been buried by lobbyists thus far. Yet public polls show that a majority of Americans support sugar taxes, especially if the revenue is used for related health programs It's time to vote with science, economics, and what is increasingly seen as common sense, and restrict marketing towards kids while increasing taxes on sugar, high fructose corn syrup, and sweeteners in whatever guise they appear — with the funds earmarked for prevention — and yes, that includes prescriptions for exercise — and treatment.

The sugar status quo is increasingly bitter, rather than sweet. But it's profitable for some folks, even if others have to pay, and thus change seems long in coming. I suspect that eventually, however, good sense will win out here.

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