The Sweet and Lowdown on Sugar
KELLY D. BROWNELL and MARION NESTLE / NY Times 23jan04
To lose weight, people must eat less, be more active, or both. The first part of that prescription, of course, raises the question, "Eat less of what?" For the World Health Organization and most nutritionists, one obvious answer is sugars. But the United States and American food companies seem to have a different idea.
Last spring, the W.H.O. and another United Nations group, the Food and Agriculture Organization, issued a report called "The Expert Consultation on Diet, Nutrition and the Prevention of Chronic Diseases." It suggested a strategy of dietary changes for individuals, including limits on sugar consumption, as well as policies that might make it easier for people to eat more healthfully.
The United States Department of Health and Human Services should have applauded, but instead it produced a 28-page, line-by-line critique centered on, of all things, what it called the report's lack of transparency in the scientific and peer-review process. Although the department framed the critique as a principled defense of scientific integrity, much evidence argues for another interpretation — blatant pandering to American food companies that produce much of the world's high-calorie, high-profit sodas and snacks, especially the makers of sugars, the main ingredients in many of these products.
The critique was sent to the W.H.O. in the hope that its executive board would reject its report when it met this week. Instead, the board decided to send the strategy to its full membership for a vote in May, but, under pressure from some member states, it gave dissenters an extra month to comment before a final draft is issued. If accepted in May, the strategy won't be binding, but it would provide guidelines to countries seeking to reduce obesity.
To understand the significance of this battle, it is crucial to know that Americans are not alone in gaining weight. Obesity is now a global epidemic, with the International Obesity Task Force estimating that one billion people are overweight or obese. In all but the poorest countries, obesity and its consequences — rising rates of heart disease, Type 2 diabetes, and so on — are overtaking malnutrition as major health problems. Modern society, with its overabundance of high-calorie food, makes healthful eating difficult.
That the food industry is disputing the W.H.O.'s science is all the more astonishing because the report is notable for the stunning banality of its dietary recommendations: eat more fruits and vegetables, and limit intake of foods high in fats and sugars. Such recommendations are no different from those issued by governments and health organizations since the late 1950's and are thoroughly supported by both science and common sense.
One recommendation in the report raised particular ire — that people should limit "free" sugars. "Free" refers to sugars added to foods that aren't thought of as sweet — mayonnaise and peanut butter, for example — as well as the more obvious soft drinks, snack foods, pastries and candy. The report suggests an upper limit of 10 percent of calories from added sugars — about the amount recommended by our own Department of Agriculture's food pyramid. According to the Agriculture Department, if you eat 2,200 calories a day, you should limit added sugars to 12 teaspoons. The typical American consumes 20. Added sugars made up 11 percent of calories in American diets in the late 1970's; they now are 16 percent overall and 20 percent for teenagers. By itself, that 20-ounce Coke or Pepsi in a school vending machine provides 15 teaspoons of sugars.
Understandably, industry lobbyists are uneasy about calls to cut consumption of sugars. One trade group, the Sugar Association, demanded that the W.H.O. remove an early draft of the report from its Web site and conduct another scientific review. It also vowed to use "every avenue available to expose the dubious nature" of the report, including asking members of Congress to challenge the United States' $406 million in contributions to the W.H.O.
When food industry executives or government officials complain about the lack of sound science, self-interest is generally at work. Internationally known scientists drafted the W.H.O. report. The report comes to obvious conclusions. Threatened by such conclusions, food companies and their friends in government try to pick apart the science, ridicule the process, and delay action, just as the cigarette industry did for so many years. Senators Larry Craig and John Breaux, co-chairmen of the Senate Sweetener Caucus, asked Health and Human Services Secretary Tommy Thompson to call on the W.H.O. to "cease further promotion" of the report, while trade associations for the sugar, corn refining and snack food industries questioned the report's legitimacy and asked for Mr. Thompson's personal intervention. They got it.
By making its position on the W.H.O. indistinguishable from that of the food industry, the Bush administration undermines the efforts of more forward-thinking food companies and threatens public health. Its action underscores the need for government to create a wall between itself and the food industry when establishing nutrition and public health policy. Recommendations to cut back on sugars may not please food companies, but it's time to stop trading calories for dollars.
Kelly D. Brownell, professor of psychology at Yale, is author of "Food Fight: The Inside Story of the Food Industry, America's Obesity Crisis, and What We Can Do About It." Marion Nestle, professor of public health at New York University, is author of "Food Politics: How the Food Industry Influences Nutrition and Health."
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