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Is Sugar the New Tobacco?

Sugar is in the headlines of the New York Times.

The Extraordinary Science of Addictive Junk Food” discusses… well… the extraordinary science of addictive junk food.

Its adapted from the book Salt Sugar Fat: How the Food Giants Hooked Us which describes the food industry’s nefarious efforts at engineering food to keep us hooked, amplifying the obesity and diabetes epidemics in the process.

Coke Blinks” describes The Coca Cola Company’s entry into the obesity debate, an attempt at coming clean on its (not) role in the obesity epidemic, and its take on how to properly address the problem.  The effort was panned by critics and almost became a running joke complete with remix videos and social media memes.  These critics did, however, find solace in the fact that the mighty Coca Cola had to take the time to make a video at all.  Coca Cola is listening — to the New York Times at least.

But the war on sugar isn’t only taking place in the pages of The New York Times. Even if the most visible legal battles surrounding access to sugar have taken place in the Empire State.  New York City is only relevant insofar as it is slightly ahead of the curve (like its proud to claim on most issues) of a moral arc that everyone is sure to ride eventually.

Mayor Bloomberg’s attempt to ban the sale of large sized sugary sodas isn’t as simple as banning smoking indoors, or mandating calorie counts on food menus or even legalizing same-sex marriage.  Its actually more radical, its ideological and legal drivers (and consequences) more contentious1.

The political and food-activist left considers the proposed ban a necessary injunction on the fast food industry’s assault on our bellies and kidneys (and future health of our nation).

Others consider it a violation on our individual liberty—we should be able to consume what we want, when we want.

Even if what we want is a toxic, addictive drug.

And it is the use of terms like “toxic” and “addictive drug” to describe sugar that is the fulcrum in this debate—suddenly we look at every spoonful differently, and we begin to entertain the idea that maybe….well….this is a substance whose access should be limited or controlled.

Once we’ve done that, the policies fall right in line, and suddenly this debate sounds a lot like the tobacco debates of yesteryear.

I use “yesteryear” loosely, as the public-tobacco industry relationship will always be contentious, at least as long as smoking remains the number one cause of preventable death in America.

But its been over 10 years since the Tobacco Master Settlement Agreement (MSA), a mega settlement between the four largest tobacco companies and 46 states, a resolution to a lawsuit that attempted to hold the companies accountable for creating disease burden that was (literally) costly to states.

Many of the same attorneys from the MSA have shifted their attention to the big food industry. The idea is that many of the arguments are the same: a company is selling an addictive product that creates a costly disease burden that the state (and nation) fits the bill for.

Soda CigsThe differences between sugar and tobacco are plenty and obvious: tobacco can only be purchased by adults, can only be sold in certain places, is not ingested in food.  Sugar on the other hand, is everywhere, can be purchased by everyone, and very cheaply.

And while even tobacco’s defenders would agree that its best consumed by adults in moderation, sugar is such a staple of American childhood that it’s challenging to imagine our childhood without it.

The differences only begin there, and much of the compare-contrast between sugar and tobacco involves the physiology of addiction, can be mapped out in terms of cell-signaling and neural pathways.

This can either be overkill or absolutely necessary, depending on what debate one wants to have.

For example, we could make the following argument:

If we regulate tobacco, and sugar is as physiologically addictive, toxic and costly draining, then we should regulate it similarly.

This is an argument that must be spelled out in cellular terms, with an explicit medical definitions of “addictive,” one that lays out a clear spectrum of addictiveness and draws a clear line where acceptance of one addictive substance ends, and the non-acceptance of another begins.

There is a safer, more vague, but more appropriate version of this argument:

 Given sugar’s addictive properties and, in particular, its affect on children, we are justified in policy change that limits access and/or consumption of excessive servings of sugar-containing foods.

More and more people seem to agree.

Big sugar has its individual liberty vs. state control talking points lined up.  The liberty debates, summarized earlier, say that the state shouldn’t control what we consume, that Bloomberg banning the sale of large sugary drinks is morally wrong because it takes the choice away from individuals, yada yada yada.

Friends of Bloomberg might respond that there is nothing individual about the financial burden of the diabetes and obesity epidemics.

Plus, few conservatives adopt the puritan stance that state control of certain substances is a bad thing, and even fewer would believe it without some…encouragement ($$$) from the junk food and soda industries. Individual liberty, as a moral doctrine, is especially important when people in influential positions are paid to argue that individual liberty is….especially important.

And even conservatives have come a long way since many called the FDA an infringement of individual liberties.  Almost everyone agrees than an FDA is necessary because the consumption of food and drugs isn’t nearly as rational a process as we wish – everything that tastes good or makes us feel good is not good for us or for society, and yeah, sometimes you need to put faith in a bureaucracy to prevent us from eating the breakfast cereal with the cranberry-tasting paint chips.

SugarWhat will the future hold?  Tobacco, despite its political losses, continues to turn a profit.  It occupies a large niche and will do so indefinitely.  There are new smoker markets in the developing world to explore, new generations of people to kill. The public campaign against smoking has certainly been affective, however, as a new, mostly negative social stigma is associated with smoking.

But how will big sugar survive the legal, medical and ethical onslaught?

The continued run of investigative journalism condemning its role in chronic disease?

The pending lawsuits, the PLoS Medicine articles, the op-eds?

More than likely, the industry will adapt, the snacks will change, the message will shape-shift.

And in the end, sugar will survive.

But will we?


About Cheekay Brandon

Cheekay Brandon is an academic computational epidemiologist and data scientist. A former amateur boxer, he also studies and writes about health inequities, violence, sports, technology, and futurism. Follow him on twitter: @bigdata_kane

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