By Brooke Berger |
The overabundance of sugar in the American diet isn't just making us fat, it's hurting our health. Scientific evidence shows that too much sugar—i.e., the amount consumed by the average American—leads to metabolic disease, which leads to chronic illnesses including heart disease, stroke, cancer, and diabetes. Sugar overload also creates a cascade of chemical changes in the body, turning off the hormones that tell us when we've eaten enough, and affecting brain neurotransmitters that leave us craving more.
Sugar needs to be regulated like other toxic and addictive substances. The regulation can take on a market-based approach that would improve health while actually increasing choice.
For decades, America's main strategy to prevent obesity and metabolic disease has been education: nutrition labels, public service announcements, and, mainly, school-based health education. There is now solid evidence that health education doesn't work in changing behavior, especially for substances with abuse potential. The fundamental problem is that we live in what addiction researchers call a saturated environment. You have to go out of your way to find a drinking fountain or a fresh apple, but junk food counters and vending machines line the walls of workplaces, airports, shopping centers, and even schools. Our saturated environment doesn't just make sugar-laden products easy to get—it makes them hard to avoid.
In their New York Times bestseller, Nudge, two professors from the University of Chicago point out what public health researchers have known for years: Most of the time, most of us tend to eat and drink what's in front of us. The best way to promote healthy weight and metabolism, then, is to make the healthy stuff cheaper and easier to get than the unhealthy stuff. These authors describe a simple experiment that vividly illustrates the point. A school cafeteria lady put the low-fat milk on the front shelf while the sugary drinks went up high and in back. Guess what? This increased milk consumption while helping kids get off the sweet stuff.
Effective public health regulation is all about the nudge. It's about making healthier options easier and cheaper to get, and asking people to reach a little farther for products harmful to health. More importantly, it's about nudging producers and distributors to increase the availability of healthier alternatives through market incentives: by ending subsidies and prorating taxes based on how much sugar has been added to the product. There is now a vast body of international research showing that such simple strategies are easy to implement and tangibly affect population health.
But one question remains. How is it possible that regulating sugar will actually increase personal choice? Well, we all know that junk food companies have massive marketing departments working 24/7 to figure out ways to nudge us toward their products. That's why candy in the supermarket checkout aisle is at eye level for a child, and why the milk is at the back end of the store. That's why 80 percent of the foods in America are laced with added sugar—to make us want to buy more and more of these products.
Of course, nobody wants a government bureaucrat telling us what we can eat and drink. But neither should powerful corporations tell us what to eat and drink by continuously nudging us toward products that undermine our chances for a long, healthy life.
About Laura Schmidt Professor of Health Policy at the University of California-San Francisco
Keith T. Ayoob Director of the Nutrition Clinic at the Rose F. Kennedy Children's Evaluation and Rehabilitation Center at Albert Einstein College of Medicine.
Kristina Lewis Doctor and Researcher at the Obesity Prevention Program at Harvard Medical School