Last week, Robert Lustig and colleagues at UCSF published a letter in the journal Nature about the public health consequences of consuming sugar. The letter is behind a paywall, but you can view a brief (5:30 min) interview with the authors here. The basic idea is that, like excessive consumption of alcohol or tobacco, there are negative individual and societal consequences resulting from the excessive consumption of sugar. Therefore, the authors argue that some regulation of sugar (like alcohol and tobacco) might be in order. The authors also argue that although the thought of regulating sugar might seem radical or outrageous to some, many public health measures or campaigns (e.g., distributing condoms or getting vaccinations) were controversial before becoming mainstream.
So, what exactly would the regulation of sugar look like? When I teach students about drug policy, I try to make absolutely clear that there are BOTH societal costs associated with drugs (overdoses, accidents, health problems) AND societal costs associated with drug policy (enforcement, incarceration, black markets). As such, one cannot have a serious conversation about drug policy without acknowledging both types of costs (this is often where the conversation between “drug legalizers” and “drug warriors” breaks down). Moreover, we need to remember that the ultimate goal is to reduce both types of costs – or in the words of an actual policy expert, we need to find ways to have less crime and less punishment.
So, from a policy perspective, this is where the rubber meets the road. How dangerous is sugar? Is there any safe level of sugar consumption? What type of regulations should be employed? Would those regulations result in other negative consequences?
This is where things can start to get pretty hairy. If sugar was banned outright or taxed and regulated at a high or differential levels, we could expect the growth of black markets (see: alcohol during prohibition or smuggling cigarettes across state lines). If the regulations involve attempts to limit access to sugar like we try to limit access to alcohol (e.g., by age, quantity limits, location of purchase, or time of day), then what would the costs associated with enforcing these rules add up to, and how would those costs compare with the public health costs of free access to sugar? You might also wonder if different types of sugar would be taxed or regulated in different ways. Should fructose be regulated differently than sucrose, lactose, or maltose? And, what might the consequences of that regulation be? Should a can of soda/pop be regulated differently than a piece of fruit or a glass of orange juice? Why?
I don’t have all of the answers to these questions, but I do think that they are good questions to be thinking and talking about. In addition, if you like the idea of regulating sugar, you can start regulating it in your personal life immediately. For example, some diets impose quantity limits (no refined sugar and no more than one serving of fruits or berries per day). Some people restrict availability by not bringing certain products into their home. And, some people restrict access based on age by not allowing their children to consume excessively sugary beverages. So, what do you think folks? Should sugar be regulated on a large scale? How do you already regulate your sugar intake?