Tuesday, May 3, 2011

Fructose, Public Policy, and The Low-Fat Re-Education Camp (Short Post)

by Chris Masterjohn

Here's another short post in honor of my readers with ADHD.

One subject that came up in Dr. Lustig's recent interview on "Sugar and Health" is the need to formulate public policy in order to reduce fructose consumption.

I think, as advocates of real traditional foods that will invariably have differing political dispositions, we need to make sure we don't become divided over politics, but the politics are still a reality that we need to deal with.

I agree that we need to modify public policy in order to reduce incentives to make and eat junk food.  One thing I would support would be ending corn subsidies.  As Dr. Lustig pointed out in Sugar: The Bitter Truth, one of the main reasons high-fructose corn syrup (HFCS) replaced sucrose is because it is dirt cheap.  The cheapness of plastic bottles over glass bottles and of HFCS over table sugar has, according to this view, greatly increased the consumption of sweetened soft drinks.  As a result, these factors have greatly increased all the addictively sweet tastes, potentially metabolically damaging fructose, and nutritionally empty, unsatiating calories that come with these drinks.

Nevertheless, this is an area in which we need to tread very carefully.  I think it is very important that we avoid setting the precedent or accepting the principle that the government should be determining how people eat.

The reason is simple.  If they come for our fructose, they will come for our fat next.

Two years ago, Daniel Steinberg and two other colleagues wrote a review in Circulation entitled "Evidence Mandating Earlier and More Agressive Treatment of Hypercholesterolemia."

Here's a snippet:

The Ultimate Long-Term Solution

If indeed the low pre-Westernization CHD rate in Japan was, as discussed above, due primarily to lifestyle differences (diet and exercise), then our long-term goal should be to alter our lifestyle accordingly, beginning in infancy or early childhood. Is such a radical proposal totally impractical? It would, of course, take generations to achieve and would require an all-out commitment of money and manpower to reeducate and modify the behavior of the nation. Is that impossible? No. We have already shown that even a frankly addictive behavior like cigarette smoking can be overcome (eventually) with the right combination of education, peer pressure, and legislation. Would it be safe? Data are now available to show that instituting a low-saturated-fat, low-cholesterol diet in infancy (7 months) is perfectly safe without adverse effects on growth, development, and sexual maturation. . . .
The NIH has already committed itself to “wars” on obesity and diabetes mellitus. The weapons for those wars—education and behavior modification—are the same as those needed for a war on CHD. The overlaps are obvious. A concerted national public health program might dramatically reduce morbidity and mortality resulting from these 3 major chronic diseases.

Daniel Steinberg has published hundreds of papers on cholesterol, and was the chief architect of the Coronary Primary Prevention Trial and the chair of the NIH Consensus Conference that shortly followed, determining cholesterol policy for decades to him.  Steinberg carries much more weight when it comes to public policy than anyone currently bashing fructose does. 

As much as I'd love to see an end to modern junk food, I think this is going to have to be achieved without accepting the principle that the government should determine what we can and cannot consume.  If we accept that principle, we are in big trouble.

Read more about the author, Chris Masterjohn, PhD, here.


  1. True, true, true, on every level!!!!! This is a case of personal and individual responsibility. The government should no more be subsidizing corn than it should be forcing upon us rules dictating what we can and cannot eat... Getting their heads out of the sand and listening to what the research is REALLY saying however, and then using this information to write proper guidelines to educate people, that, I'd be all for...

  2. I tried to get through it, but it was too long. Perhaps you should try twitter? ;)

  3. "I think, as advocates of real traditional foods that will invariably have differing political dispositions ... this is going to have to be achieved without accepting the principle that the government should determine what we can and cannot consume."

    Of course, real "traditional" societies didn't bother too much about individual freedom—and not only as regards food choices:

    "It is not only a matter of disgrace but an actual abomination, for an Ibo woman to bear children at shorter intervals than about three years. . . ."

    Nutrition and Physical Degeneration, Ch. 17.

    I don't disagree with you, but it's nevertheless interesting to note that.

    But whether or not such a way of life would be desirable, we cannot live in the same way, of course, because our history makes us different. And one doesn't have to be a liberal ideologue to recognize that. Michael Oakeshott—who was, of course, not one of those—would point out that there's been a tendency for people to "go their own way" in European societies since at least the 12th century.


    Individualism isn't the be-all and end-all, but taking responsibility for ourselves and resenting those who have paternalistic plans for us is in the very marrow of the West.

  4. But, if the government doesn't do it, no one else will.

    I used to be quite libertarian, until I found myself being in the same position as Pepsico and Uniever in advocating 'consumer choice'. Something is really wrong when you agree with the bad guys.

    The issue is not government regulation, but rather the over-reaching lobbying influence of food companies. That's what gets little producers squeezed out.

    Your example re: corn subsidies, food companies will just buy their cheap corn from Mexico, government subsidies are merely protectionism.

    Government taxation and regulation have worked wonders on reducing cigarette consumption,why not the same for fast food?

  5. “If people let government decide what foods they eat and what medicines they take, their bodies will soon be in as sorry a state as the souls of those who live under tyranny.” - Thomnas Jefferson

  6. I agree with you. As much as I dislike junk food, low fat, HFCS, and other bad stuff, at the same time I know that once regulation starts there's no end to what can be regulated depending on current research or opinion on the people in charge.

  7. As an aside, did you see this* go round the tubes re fructose recently?

    "the dual delivery of simple sugars in [the animals'] diet somewhat mirrors the delivery of carbohydrates in high-fructose corn syrup (aka corn sugar), where its component sugars are delivered individually, Ruff says, not as sucrose with a little fructose bonus. "

    Are the sugars in HFCS "delivered individually" ... I recall that the supposed fructose expert in Taubes' recent piece in the NY Times said he couldn't conceive of a meaningful difference between sucrose and HFCS.


    * http://blog.sciencenews.org/view/generic/id/72741/title/Simple-sugar_effects_aren%E2%80%99t_necessarily_simple%2C_animal_study_suggests

  8. There has already been a decades-long smear campaign against saturated fat and cholesterol. It is hard to imagine it getting any worse! ARGH !!!

  9. The key is not government regulation of dietary choices, but rather getting government out of the diet business altogether. The disinformation supporting the lipid hypothesis of heart disease has done nothing but harm. Instead of advocating a science-based approach to diet, the government has simply advocated on behalf of special interests, like Big Pharma, the food industry and farmers.

  10. "The issue is not government regulation, but rather the over-reaching lobbying influence of food companies. That's what gets little producers squeezed out."

    No, the issue is in fact government regulation. When the government regulates, it is invariably in favor of those with the most money at stake, via their "over-reaching lobbying influence", even when the regulations cost them more up front. All costs are passed on to the consumer, including the costs of conforming to regulations.

  11. Chris: why stop at corn subsidies? All grain subsidies should be eliminated. "Without accepting the principle that the government should determine what we can and cannot consume". @#$% ! The gov't is already doing this. I can't purchase raw dairy in the state I reside in. A cattle farmer can't slaughter a cow for me without the USDA sticking its nose into our business.

  12. @Rob K said:

    All costs are passed on to the consumer, including the costs of conforming to regulations.

    Well not really, though that is a common economic assumption. Costs can only be passed on if the market can actually bear it. If not then usually the affected entities absorb the loss or eventually go out of business.

    Either way, as Chris, you and others note, having the government involved in dictating how we eat or what we should eat is a very bad idea.

    I have archived a few articles on the subject.

    The FDA Files

  13. "No, the issue is in fact government regulation. When the government regulates, it is invariably in favor of those with the most money at stake, via their "over-reaching lobbying influence", even when the regulations cost them more up front. All costs are passed on to the consumer, including the costs of conforming to regulations."

    Every government does not favour powerful lobbies over the people. Even the US government doesn't recommend eating the processed crapinabox that most peope seem to subsist on. That consequence is a result of the carte blanche granted by the market in the name of supposed 'freedom'.

  14. Strong competitive pressures drive food producers toward selling increasingly addictive products (that is to say, addictive in a concrete, neurological sense).

    Though each producer faces strong incentives, for food producers as a whole, this competition is very nearly a zero-sum game for market share (that is to say, dividing a very nearly fixed pie).

    No specific policy prescriptions follow from these observations, but they seem worth noting.

  15. “But if the government doesn’t do it, who will?”

    If the government represents “we the people”, it should and I have always wanted the government to set standards for us—based on science. The problem, more than ever, it seems, is that the government, especially the Congress, under the control of corporations, will not use science to set standards.

    If corporations control the government and the government tells us what to eat, we are indeed in trouble!

  16. A very valid concern. In my work with schools this is exactly what's occurring. While some added sugars are being restricted, so are saturated fats, food rewards of any kind, foods for birthday celebrations, even bringing any foods prepared at home (ie packed lunch). Talk about unintended consequences!

    I would like to point out though that much of the policy that influences food choice is NOT the government Dietary Guidelines and the like- it's land use planning that builds abundant fast food joints and no grocery stores, farm policy that encourages an industrial model, big food corp advantages and local food disadvantages. These are the things that impact our food environment and choices every day.

  17. Responses to everyone.

    Eric, agreed.

    Tuck, here you go: http://twitter.com/#!/ChrisMasterjohn/status/65473259273060352

    Mike, I agree. And I think "primitive" groups had wisdom we are missing beyond food, as well as things that are not worth imitating at all. In any case by advocating traditional foods, I simply mean the health-promoting patterns of food consumption.

    Suzan, me too, awesome.

    SamAbroad, I'm quite sure that Mexico is actually buying their cheap corn from us, while their heirloom breeds of corn are becoming endangered because of it. Mexico does not have this type of subsidization policy. In any case, I agree that gov't taxation and regulation could reduce fast food production but I never questioned its efficacy. What I said was that there are people who carry much more weight in public policy advocating this type of campaign against fat and cholesterol, not against fructose. Allow this campaign to target fructose, and you'll have one targeting your eggs, liver, butter, and meat. That's not going to improve the health of the nation.

    Chris, if that quote is legit, more evidence Jefferson was a pretty smart guy.

    Jo's, yep!

    Beth, yet's it's entirely plausible that free fructose/glucose could have different effects than sucrose, but the evidence of this seems inconsistent and so far poorly investigated, but I'll try to look at that study when I can.

    Michael, argh indeed. :\

    allison, agreed. Sarah, me too.

    Rob K, I agree with Michael. Costs are passed on to the consumer to some degree, with the degree depending on supply and demand equilibrium. Ultimately, prices are set by supply and demand and not cost. You can't pass on costs if people won't buy it. Nevertheless I agree with the rest of what you said.

    Karen, totally.

    rpineau_2001, I wouldn't stop there. I was trying to make the post short. ;-) I know about raw milk, and I agree. More evidence that it's not just "bad" foods that will (and are being) be targeted.

    SamAbroad, right but you still seem to be missing the point that the US gov't is actively targeting healthy foods (i.e. raw milk, other raw foods) and that people who carry much policy weight are aiming to target other healthy foods.

    Ed, well I suppose if obesity and food intake can be increased, it's not zero-sum anymore! :(

    Gary, yes.

    Real Food RD, great points, thanks.

  18. We seem to be missing the point when we blame the lobbyists. Any time the government puts itself in a position where it has the power to affect the free market, companies will lobby to advocate for their product.

    It's the "Tragedy of the Commons." All it takes is one company to lobby, and then every company MUST lobby to stay competitive with that first company. Thus, the commons, or in this case the free market independent of government, is spoiled.

    Let's not fail to account for what's really the 'Up-stream' cause of this unfortunate situation. If the governement had absolutely no say in what people ate, there would be no value in any company lobbying them. If you really want to do away with unfair lobbying, you'll limit the government's ability to dictate what we should eat.

    Hand in hand with this, you'll limit the government's ability to decide which foods should be subsidized to keep their supply vastly higher then the market demand for those foods.

    Chris - great points made here. First they came for our cigarettes, and we applauded them because it worked. Next they'll come for our fructose, and we'll applaud when that works. But when they come for our butter and bacon, and it doesn't work, we'll have no one to blame but ourselves for creating this monster.

  19. The best way to solve the problem is for people notnto buy the bad food in the first place. That is tough because they are all leptin resistant and addicted to the carbs because of chronic elevation of NPY. Moreover, the foods we need to get rid of are all loaded with omega 6 oils and fructose and they are sold thru cheap distribution like walmart. In the US I dont see us being able to go back to more expensive farm raised food that is loaded in omega threes and has no industrial seed oils on a population based scale. Nixon vowed never to make food prices a political issue and the obesity epidemic is the unintended consequence. I think science will have to make people think about their choices. I don't see the govt ever going back. Ifnenough people make the right choices the foods companies will adapt to market pressures.

  20. A free market is an utopian/libertarian myth. A consumer is not on equal footing when it deals with corporations with thousands of people and billions of dollars at its disposal. It is not perfect, but government regulations, licensing, inspection, etc., is what gives the consumer a fighting chance to not get poisoned, made ill, get ripped off, etc. It is up to us as citizens to make sure that we are properly represented, to control the influence of lobyists, and to make sure the laws and regulations are equitable.

    Fat chance, I know, but much better than with laissez faire, let the markets regulate themselves nonsense.


  21. I think expecting a truly free market to ever occur is somewhat fantastical, as is expecting the government to properly regulate the food industry in a spirit of science, wisdom, and in a way that maximizes everyone's health. I don't think it's necessarily an either/or question. It's a matter of what specific level we are willing to tolerate and what level we are adamant about rejecting, and what level in between we consider to have somewhat ambiguous potential for negative or positive effects. I think it's clear that, say, banning, taxing, or restricting high-fructose corn syrup or hydrogenated vegetable oil could have positive effects, but I think it's also clear that this level of regulation is very similar to placing similar restrictions on important foods like meat, butter, and eggs. The people who want to restrict meat, butter, and eggs, carry more weight than the people who want to restrict fructose. So I think it is naive to expect we can ban or tax or restrict HFCS without the same thing happening to our butter and eggs.


  22. Low fat/cholesterol at 7 months?

    Logically, would Steinberg be against breast-feeding babies after 7 months?

    I certainly agree with your premise here. We are better off not relying on government. Here in "China's Quarry", the junkfood tax seems to be gaining momentum as the moment. It does seem like anything with calories in it will be branded unhealthy!

  23. Chris Masterjohn said

    If they come for our fructose, they will come for our fat next.


    Excellent, excellent, excellent point.

    Even as it is, low-fat is still somehow seen as the norm, with much more fat trimmed from meat than used to be the case (I speak from England, but I think it's the same there). They almost came for our eggs ... we were only supposed to eat about two per week! (So much for Choline).

    And were they even right over tobacco? Someone whom I won't quote but whom I respect thinks it wasn't the tobacco but diesel fumes, since people used to smoke more widely at a time when there wasn't much lung cancer. Not that I want to be on the side of the tobacco companies. But diesel PM10s have been eliminated....only to be replaced by PM2.5s which are even worse, or so I am led to understand.

  24. I always understood that grains and vegetable oils were highly subsidized and encouraged. Yet last week I saw a headline going around on FaceBook about the evil government subsidizing the meat industry and trying to get us to eat more meat. I confess I didn't read further, but I saw a lot of commentors jumping on the evil meat bandwagon.

  25. Just a point, banning smoking is as much concerned with smokers as it is with passive smokers. Poisoning yourself is one thing, poisoning other people who clearly do not agree, is quite another. So please do not give this example without mentioning this too.

  26. Anonymous,

    Thank you, that is an important point. I brought up smoking to see what kind of techniques would be employed against fat or fructose, of course, and not to comment on the ethics of smoking legislation.


  27. As others have pointed out, they have already come for our fat. In fact, one of the disturbing things about the AHA statement of sugar that Lustig is proud of, is that it does not explicitly suggest that we have to back down on fat.

    But government can do many things beyond punitive measures. Public hearings. Oversight committees. If we held the science to account, then we could ask whether industry or society in general is or is not following the science. As long as the ADA recommends sugar -- it really is a recommendation -- there is no reason why industry should not make it available.

  28. This comment has been removed by the author.

  29. I think that low carb diet is best for those peoples who wanna loss some weight ...But still they have needed to do some routine exercises ...
    gyms in spokane wa


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