Gary Taubes, author of, “Why we get fat” and “Good calories, bad calories” has a nice piece out in the NYT Magazine, which poses the question, “Is sugar toxic?” The question is an interesting one to ask and the article is worth reading in it’s entirety. However, as a faculty member in a Department of Pharmacology and Toxicology, there were a couple of statements that caught my attention.
1. A former FDA administrator who now consults with the Corn Refiners Association is quoted as saying that sugar and high-fructose corn syrup might be toxic, but so might any substance that is consumed in ways or quantities that are unatural for humans and that the key question is at what point does a substance go from being harmless to harmful.
This is a great point. A basic principle in pharmacology and toxicology is that you must study the entire dose-response function to really know what you are dealing with. It is always risky to draw strong conclusions from simply comparing two points or two doses to each other. As such, studies that examine a range of acute and chronic “doses” of fructose relative to sucrose or complex carbohydrates could be quite telling. A related point pertains to relative toxicity. It is true that all sorts of substances such as water or salt can be acutely toxic (i.e., fatal) in large enough quantities. So, we must ask how wide a margin of safety we can expect for various substances. Lastly, it is also important to define what we mean by acute and chronic “harm” or “toxicity,” especially when discussing biochemical measures such as glucose tolerance, insulin sensitivity, or LDL levels.
2. Robert Lustig, of YouTube “Sugar: the bitter truth” video/lecture fame, is quoted as saying that sugar and high-fructose corn syrup are certainly not acute toxins of the kind that FDA typically regulates, but are rather chronic toxins in which the detrimental effects occur over months to years.
This makes me think of cigarettes, which for a long time were regarded as different from the “intoxicating substances” such as alcohol and illicit drugs because of the relative lack of acute impairment from tobacco/nicotine. Typically, the predominant harms from cigarette smoking (cancer, emphysema, heart disease, COPD, etc. ) come with chronic exposure over months to years. And, guess what? FDA just got regulatory authority over tobacco products (about 45 years after the first major report on smoking and health from the Surgeon General). Could the regulation of fructose be in our future?