UCSF pediatric endocrinologist and childhood obesity advocate and policy wonk Robert Lustig, MD is always willing to state his mind when it comes to sugar. Apparently people are listening. Ever since one of his local lectures entitled Sugar: The Bitter Truth was posted to YouTube last July, nearly 500,000 people have viewed this 90 minute video. The resonant chord Lustig struck led to an appearance on ABC News Nightline in March.
Dr. Lustig, Director of the UCSF Weight Assessment for Teen and Child Health (WATCH) Clinic, recently published in Nature Reviews that fructose is a primary determinant of many chronic metabolic diseases affecting this generation — not only type 2 diabetes, obesity, heart disease, and the metabolic syndrome – but also chronic kidney disease and nonalcoholic fatty liver disease (the most common liver disease worldwide). Because fructose is toxic in large quantities and is metabolized in the liver, it causes the same type of liver damage as does alcohol. It also alters brain signaling of satiety and reward, and stimulates appetite in an almost addictive manner, causing greater food consumption, and perpetuating a “vicious cycle” of consumption and disease. Lustig and colleagues recently received an NIH grant to study the role of fructose restriction in disease prevention in children.
Fructose is a component of the two most popular added sugars: sucrose or table sugar, and high-fructose corn syrup, found in abundance in soft drinks and processed foods. Before 1900, Americans consumed approximately 15 grams of fructose per day (4% of total calories). Today, adolescents consume nearly 75 grams per day (roughly 12% of total calories). To win this dangerous battle against fructose, Dr. Lustig is convinced that education is not enough, but rather that aggressive public policy solutions will be required to help regulate added sugars in food products.