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Sugar by any other name
January/February 2005
by David L. Katz

David L. Katz, director of Yale’s Prevention Research Center and an associate clinical professor of epidemiology and public health, is the author of The Way to Eat.

Epidemic obesity is arguably the gravest and most relentlessly worsening public health threat facing the population in the United States. While not easy to fix, the obesity epidemic is simple to explain, a fact often obscured by sales pitches, pseudoscience, and unsubstantiated theory. The truth is, we get fat because we can. We have a constant abundance of tasty calories, and an array of technologies that does everything our muscles used to do. Our ancestors did not have will power that we lack; they simply lacked our video games and candy-bar vending machines.

Human beings are so utterly ill prepared for the toxicity of the modern nutritional environment that it would be fair to compare us to polar bears in the Sahara Desert. Polar bears are adapted to soak up and retain heat because they live in a place where heat is scarce—a limiting commodity in the struggle to survive. Homo sapiens is adapted to soak up and retain calories because we have always, until now, lived in an environment where calories, along with sugar, salt, and dietary fat, were limiting in our own struggle to survive. We overeat in the modern environment for many of the same reasons that polar bears would overheat in the Sahara.

But it’s not quite fair to say that Homo sapiens has no native defenses against the toxicity of the modern food environment. We have one: large brains. Yes, we are smarter than the average bear.

In theory, we could fix our nutritional ills by reengineering our environment so that it more closely resembles our native habitat. But the food industry will resist any effort to make eating less the cultural norm, because eating more translates into enormous profits.

The other way to fix what ails us is to outthink our troubles one food choice at a time. With the right knowledge, skills, and strategies, the average American consumer, and the average American family, could potentially navigate the hazards of the modern nutritional environment, achieving better health and lasting weight control.

Among the obstacles are food labeling often more arcane than informative, and food packaging accessorized with beguiling Madison Avenue deceptions. Food labels can and should be vastly simplified. They might, for example, indicate the overall quality of food with a color code: green for foods high in nutrients and low in calories; yellow for foods high, or low, in both nutrients and calories; and red for foods high in calories but low in nutrient value. A clear, straightforward system that tells consumers exactly what foods help and what foods can hurt would put knowledge in the hands of those who can use it.

But don’t look for a good, usable food labeling system without a long political effort. The reason is that, in critical ways, the interests of the food industry and of food consumers diverge.

We, the consumers, generally want good taste and would prefer good health into the bargain if we can have it. The industry wants profits. To achieve its aims, the food industry foils ours.

Food companies routinely add sugar to salty food and salt to sweet food, because flavor variety stimulates appetite. They add sugar, in particular, to the food supply in copious amounts because it is a universal taste preference, because the more of it we eat the more we want, and because federal subsidies for corn growers have made it cheap and readily available to manufacturers in the form of corn syrup. And corn brings a side benefit for the manufacturers: now, little of the sugar we consume each day is actually called “sugar” on their labels. Much of it goes by the name of “high-fructose corn syrup”—technically correct, but deceptive in spirit.

Similar shenanigans are in play with dietary fat. Some years ago, the food industry relied heavily on animal fats. These fats are highly saturated—that is, the carbon atoms in their molecules are carrying many hydrogen atoms. This makes them chemically stable, because they offer few sites where oxygen atoms from the air can bond with carbon atoms in the fat to create different (and less tasty) chemical substances. Hence: low rancidity rates. That means long shelf life at room temperatures, a very attractive commercial property. Even better from the profit-making point of view, saturated fats are also solid at room temperatures.

Then consumers learned that animal fats were clogging up our arteries, so the food industry gave us vegetable oils. But, cleverly, they found and used the rare vegetable oils that are saturated—coconut and palm kernel oil. When consumers were informed that these “tropical” oils are rather like lard in disguise, we got the next great innovation: trans fat. Trans fat is formed when naturally unsaturated oils, such as corn or soybean, are bombarded with hydrogen. The result is “partially hydrogenated” fat. It sounds innocuous, but it’s a Frankenfat, an artificial form of monounsaturated oil that acts in the body like saturated fat, if not worse.

The Food and Drug Administration will require manufacturers to note trans fat content on food labels starting in January 2006. So food labels can be improved through legislation. But the fundamental simplification of labels that is needed in order to take the heavy lifting out of thoughtful grocery shopping—though a consummation devoutly to be wished—is unlikely any time soon.

But perhaps we can more readily fight the system by working with its natural tendencies, rather than against them. First and foremost, the food industry is just trying to keep the customer satisfied. We can, potentially, remake the modern food supply merely by making better food choices. Look around: the somewhat mad proliferation of “low carb” products in the past few years is not the result of courtroom or Congressional heroics, but an ordinary case of supply driving demand. The millions on Atkins or South Beach diets simply voted at the cash register, and the food supply reinvented itself to accommodate.

If consumers look past the pseudonyms and pseudoscience on food labels to find—and buy—plain old nutritional quality, we can create our own checkout counter plebiscite.

Here are the four things to look for on food labels. First: avoid “partially hydrogenated oil.” This is harmful trans fat; when you see it, step away from the box, and nobody will get hurt. Second: avoid, to the extent possible, high-fructose corn syrup. Third: in all grain products (breads, cereals, crackers, chips), fiber is your friend. Look for at least 2 grams per 100 calories to know that some whole-grain nutrition has been retained. And fourth: in every food category, compare the length of the ingredient lists on the different products, and then choose the one with the shortest list. It general, it will be the least processed, and the most wholesome.

Judging food by its cover is fraught with hazard. Sugar, salt, and fat all go by aliases, and sales pitches sublimate any inconvenient facts. But an educated consumer can see through this smokescreen. So, although our food supply is in many ways a mess, we have the ability to start fixing it every time we shop. Simply demand better.

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