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Bittersweet Conclusion

June 12, 2013
by Rachel Gross
A grocery aisle of sugary cereals

New evidence says sugar is causing diabetes worldwide.

In 2010, clutching a cup of coffee, Paula Yoffe ’11 faced a dilemma. Should she add sugar?

“And then I thought, oh my gosh, of course not,” Yoffe recalls. The beverage’s intended recipient, Dr. Robert Lustig of UCSF, had become famous when his lecture on the detrimental health effects of sugar was posted on YouTube and went viral. According to Lustig, study after study indicated that sugar was toxic. Now his latest research indicates that sugar, not obesity, is the likely cause of Type 2 diabetes worldwide.

“Needless to say, that coffee was black,” says Yoffe.

Not many undergraduates get the chance to work with such a high-profile physician. But during her senior year, Yoffe, an integrative biology major, began collaborating with Dr. Lustig and Dr. Sanjay Basu at Stanford University on what Lustig calls his “big kahuna”: the first global study to all but eliminate obesity as a factor in the skyrocketing rates of diabetes worldwide, and to suggest that sugar consumption is to blame. For the paper, Yoffe helped compare consumption—estimated by the amount of food available in each country—to diabetes trends across 175 countries. The results, published this February in the journal PLOS One, “point the finger squarely at sugar,” says Dr. Lustig.

To get statistics on diabetes, sugar, and other foods (including oil, milk, meat, and fiber), Yoffe contacted the World Health Organization, the UN’s Food and Agricultural Organization, and the International Diabetes Federation. The researchers then controlled for obesity. The result: Whether or not people were obese, their sugar consumption scored as the main culprit. One can of soda a day, the researchers found, increased the risk of developing diabetes by 1.1 percent—11 times as much as 150 nonsugar calories.

Given that we’re hardwired to crave sweetness, coupled with the ubiquitous ads for sugary treats, villainizing sugar will be no easy task. But that’s exactly what Yoffe and Dr. Lustig think should be done, and they’re not alone. The anti-tobacco advertising campaigns of the 1990s had the right idea, says Dr. Brian Flay, who does research at Oregon State University on risky behavior in youth. Educate children young about the sugar industry’s influence on what they eat, he recommends. “Make them aware their behavior’s being manipulated.”

That may not be enough, says Dr. Lustig, who has worked with obese six-month-olds. If sugar is addictive—and he believes it is—then it’s not just kids’ minds that need to be changed. It’s their environments, as he argues in his new book, Fat Chance. Yoffe agrees: “When people think of sugar, they think of candy bars and soda. But it’s in milk products, cereal, beef jerky. It’s in our bread,” she says. If push comes to shove, Lustig would also emulate the fight against Big Tobacco—with litigation.

For Yoffe, the research has steeled her own resolve. Although still tempted by sugar, she says, “Every time I get near a soda machine, I think of Dr. Lustig and how he would be super-disapproving.”

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