Synopsis: Many experts disagree over the roots of the obesity crisis some 40 years ago. One well-known expert describes why he believes sugar is to blame, and the changes in the market and government advisories that made sugar a much heavier part of our diets.

Host: Nancy Benson. Guest: Dr. Robert Lustig, pediatric endocrinologist, University of California, San Francisco, President, Institute for Responsible Nutrition and author, Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity and Disease

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16-12 The High Health Cost of Sugar

Nancy Benson: The extent of America’s obesity epidemic is indisputable. About two-thirds of us are either overweight or obese, and it’s overtaken smoking as a source of health problems and shortened lives. But there’s not a lot of agreement over how we got into this mess and what that says about how we can get out of it. The quick and easy response is simply to blame people for eating too much and exercising too little.

Dr. Robert Lustig: Everyone thinks obesity is about calories and calories are a math problem. You eat too much, you exercise too little and after all, you eat too much that’s gluttony, you exercise too little, that’s sloth. Gluttony and sloth, two of the seven deadly sins therefore, personal responsibility.

Benson: Dr. Robert Lustig is a pediatric endocrinologist at the University of California San Francisco, President of the Institute for Responsible Nutrition and author of Fat Chance: Beating the odds against sugar, processed food, obesity and disease. He says the enormous increase in dietary sugar is the real reason for the obesity epidemic, and it goes far beyond the calories in sugar and other foods. But he says food companies love to make us think it’s our own fault. It’s a concept invented not that long ago by another industry trying to protect itself.

Lustig: The tobacco companies in 1962, they were getting killed on the science and they had to invent another reason for you to smoke. They said, ‘Well, you get to choose. You get to choose if you smoke. It’s your own choice. Nobody put that cigarette in your mouth.’ Now the question is, is it personal responsibility when the substance is addictive? Does that change the argument? Clearly, it does because every substance of abuse is now considered a public health problem rather than a personal responsibility problem.

Benson: So is Lustig saying that sugar is addictive? He says the evidence clearly shows that the answer is yes.

Lustig: Sugar does every single thing to the brain that any other substance of abuse does and that sugar also causes addiction in about 20% of the population. So people say, ‘Well, how can sugar be addictive? Sugar is a food. How can a food be addictive? You need food to live, you need sugar to live.’ These are the arguments that are brought out. Well, guess what? You don’t need sugar to live. Not only do you not need sugar to live, but you actually live way better without it. Turns out that the molecule in sugar that we love, that’s sweet, that actually activates the reward center called fructose, there’s no biochemical reaction in the body that requires it, that when consumed in excess, it causes cell, metabolic, and human damage and it’s addictive and we love it anyway.

Benson: Lustig says there’s only one other energy source that meets those same qualifications–alcohol.

Lustig: Alcohol is not a food. No one would call alcohol a food. 40% of America are teetotalers and as far as I know, there’s nothing wrong with them. They may be missing out on a little fun but otherwise perfectly healthy. Alcohol is not a food, alcohol is a toxin and we regulate it as such. It turns out, sugar meets every single criteria that alcohol does, so sugar is not a food either. And if sugar is not a food and sugar does the exact same thing as alcohol then sugar’s addictive. And if sugar’s addictive, then how does personal responsibility work?

Benson: But if sugar is the main cause of obesity, why has it been a huge problem only over the last 30 years or so? Granulated sugar has been in widespread use for hundreds of years, and it’s presumably been addictive all that time. So what changed? Lustig says two major things at about the same time. First, sugar got cheaper than it had ever been before. And second, experts and the government labeled fats in the diet as a far greater danger than they really are.

Lustig: Those two things pretty much happened at the same time. So sugar got cheap because of something called high fructose corn syrup and that was brought to our shores in 1975 and what that did was that provided competition for sugar cane and it was a lot easier to harvest and it was miscible in liquids so it didn’t crystalize out and it was made on our own shores and we didn’t have to import it. So it was half the price of sugar, so it drove the price of sugar down so all of a sudden, sugar was cheap. But to that point, it was kind of on the expensive side especially since the tariffs kept the price propped up.

Benson: The second factor was the very first US Dietary Guidelines, issued in 1977, which dictated that people should eat low fat.

Lustig: Well, low fat tastes like cardboard and the food industry went, ‘What are we going to do to make people eat all this low-fat garbage we’re making?’ And what’d they do? They spiked it with sugar because when you spike it with sugar, people come running. So they made an entirely new set of products and they developed an entirely new industry around low-fat and fat-free, basically based on sugar as the substrate so our sugar consumption just jumped through the roof and that process developed the diabetes, obesity, fatty liver disease, cancer and dementia epidemics that we have today.

Benson: But Lustig says sugar doesn’t have to make people fat to make them unhealthy. Take diabetes, for example. Many experts say obesity causes diabetes. But Lustig says that turns diabetes into a simple “calories in, calories out” calculation, which doesn’t explain everything. It also lets food companies off the hook.

Lustig: The food industry can invoke personal responsibility like, you know, ‘Hey! Nobody put that Cheeto in your mouth and if you don’t exercise, you know, it’s your own damn fault.’ So this is a great way to dissuade your culpability. So if it’s about obesity, the food industry wins. But it’s not about obesity and here’s why: Number one, there are countries that are obese without being diabetic. And there are countries that are diabetic without being obese such as Iceland, Mongolia and Micronesia are obese without being diabetic. India, Pakistan and China are diabetic without being obese. If you have to have obesity for diabetes, then how do you explain India, Pakistan and China? They have a 12% diabetes prevalence and they’re not fat. We, the fattest nation in the world, have a 9.3% diabetes prevalence. They outclass us in diabetes and they’re not fat. If it’s about obesity, how do you explain it?

Benson: And while obesity is increasing at 1% per year worldwide, diabetes is increasing much faster, at 4% per year. So Lustig says obesity can’t explain it all. It also can’t explain the diabetes increase in the United States.

Lustig: If you look at the rate of diabetes increase in this country, it’s going up 25% in the obese people. Well guess what? It’s going up 25% in the normal weight people, too. It’s going up just as fast in the normal weight as it is in the obese. Well if it’s about obesity, how do you explain that? Well, you can’t. Bottom line, it’s not about obesity. The food industry wants you to believe it’s about obesity, but it ain’t. It’s about our specific food environment and it’s specifically about how our body metabolizes the food stuffs that enter it and what damage they cause in the process. And of all the different food stuffs we consume, sugar is the one that does the most damage because it affects the liver and it affects the brain. And it causes the type-2 diabetes and fatty liver disease and it affects the brain to make you want more.

Benson: Lustig’s conclusions are controversial but he says there’s evidence for them. He put a group of more than 40 obese children on a low sugar diet and found that in just ten days, their markers of poor health, such as blood pressure, cholesterol and blood glucose all improved significantly, even though the children didn’t lose weight. So as far as Lustig is concerned, obesity isn’t the problem… it’s sugar.

You can find out more about Dr. Robert Lustig and his book, Fat Chance, through links on our website,

Our production director is Sean Waldron.

I’m Nancy Benson.


2 thoughts on “16-12 Segment 2: The High Health Cost of Sugar

  1. Very interesting, I used to try to catch you on the radio Sunday morning but can now listen to you any time. Love your show.


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