
Is it time to treat sugar like smoking? - notlukesky
https://www.bbc.com/news/health-48499195
======
gregmac
I started eating keto over a year ago, and found that I totally lost my
appetite for sugary and other carb-based foods, so have just kept it up.

One thing that was eye opening to me was from paying close attention to food
labels. I used to try to mostly eat "healthy", so I'd tend to buy the "low
calorie" options. What surprised me was how basically they just substitute fat
for sugar. Ceasar dressing normal has 1g carbs and 4g fat per Tbsp (45 cal),
but low calorie is 4g carbs and 1.5g fat per Tbsp (30 cal). This adds up, and
I think I was actually eating a pretty unhealthy balance of macronutrients
(fat/protein/carbs) while thinking I was eating healthy, despite my BMI slowly
creeping up over a decade to being middle of "overweight" (I'm now in the
middle of "normal" range, just from changing my diet).

Well I think treating sugar like smoking is far too extreme, I do think the
demonization of fat along with the addition of excess sugar to "healthy" food
options is a terrible combination, and that needs to end.

~~~
TazeTSchnitzel
I think the demonisation of fat might be partly a linguistic problem. “fat” is
a derogatory term for someone who is overweight, but it also happens to
describe an important component of food, so the (incorrect) connection forms
itself: eating fat = getting fat. This isn't the case in all languages, though
I don't know if that actually has meant Germany or wherever cares less about
fat content.

~~~
StavrosK
Maybe we should call it "lipids"? Not sure if that's the same.

~~~
buu700
I've always preferred the French nomenclature: carbohydrates are glucides and
fats are lipides.

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umvi
How about we start treating alcohol like smoking? For example ban alcohol
advertising like we have with tobacco and I bet society would improve in a lot
of unforeseen ways (besides the obvious reduction in alcohol related deaths
and diseases and family issues).

~~~
Alex3917
For most people, alcohol isn’t addictive in the same way that smoking or sugar
is. If you eat stuff with a lot of sugar it makes things without sugar
actually taste worse. Whereas drinking alcohol doesn’t make water taste worse
or whatever.

Also alcohol only kills 80k or so Americans per year, way less than smoking or
sugar.

~~~
llamathrowaway
Is there any reliable source to back up the claim that sugar is more addictive
than alcohol?

I am suspicious about this claim because there are plenty of people and
families ruined directly as a result of alcoholism. I don’t think sugar
addiction is causing nearly as much trouble as alcoholism, despite being a
more widely consumed and easily available substance.

~~~
ardit33
The number of "Obese People" far outweighs the number of chronic alcoholics...
we are talking about almost 1/3rd of the population being obese (i.e. not just
a bit fat, or chubby, just straight out obese).

~~~
llamathrowaway
Is obesity a sign of sugar addiction? I don’t think so. People addicted to
substances like alcohol and heroin will go out of their way to obtain these
substances breaking laws and ruining others’ lives if necessary. While obese
people are just... obese, not crazy nor dangerous. Their mind don’t get wired
by sugar to put sugar in front of decency and laws.

Not to mention sugar is not the only cause of obesity anyway. Sedentary
lifestyle, hormones, gut bacteria, and the portion sizes in the US are all
likely causes.

~~~
p1mrx
> While obese people are just... obese, not crazy nor dangerous.

If you could wave a magic wand, wouldn't most obese people prefer a healthy
weight? In aggregate, we can add up individual decisions and call the average
"human nature." The actions of society have forced individuals to live with
bodies that don't function as well as they could, so it makes sense for us to
do _something_ about the problem.

How well do we understand the causes of the obesity epidemic? Is sugar
responsible for, say, 10% or 90% of the total? If we wish to progress toward a
low-sugar future, then it would be good to have an estimate of how much good
it would do.

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jmull
FYI: This article is referring to requiring sugary products to use plain
packaging:

> ...suggested sweets, snacks and sugary drinks should be wrapped in plain
> packaging to make them less appealing, given the excess consumption of the
> sweet stuff

(I think some of the responses here are assuming the question is about
treating sugar like smoking in other respects.)

~~~
Mirioron
I think people are afraid of a slippery slope. Legislation is almost always
done in a slippery slope manner - at first you limit things a little and wait
until people accept it. After a while you limit some more, then some more and
then some more.

You can do whatever you want with sugar, but it's not going to solve the
obesity problem. Not only are carbs one of the few macro nutrients we can
digest, they're also in pretty much everything.

~~~
anchpop
What do you think will solve the obesity problem? People weren't obese like
they are now 100 years ago. Something must have changed

~~~
Mirioron
People stopped being poor. It's difficult to become obese when you simply
don't have enough food. The solution to the problem isn't going to be in the
past, because we want people to live a better life and not worse.

I think what will solve the obesity problem is education. The basic ideas of
nutrition (in terms of physics and biology) should be taught to everyone. It
should not be possible for someone to graduate high school and find the basics
of a nutritional label difficult to understand.

This should also be coupled with a better cultural attitude. People should
feel encouraged to try to lose weight when they're obese, rather than told
some form of "healthy at every size" nonsense or be made fun of when they are
at the gym. It should be seen as an ailment that can be improved rather than
something shameful. If you have a broken arm, then you're not told that it's
fine to have a broken arm, nor are you made fun of for trying to get your
broken arm fixed.

I used to be overweight and I understood that it was bad, but it was difficult
to try to improve it. The people around you notice that you're doing things
differently and you'll hear snide remarks or encouragement, but this leads to
expectations, so you try to hide it instead. That way nobody expects anything.

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impatient_bacon
God I hope so. I grew up obese and am now about halfway through undoing the
damage using a ketogenic diet. I really do think sugar sweetened drinks should
be banned for sale to children under 18, as that causes the most damage.

~~~
Mirioron
So, they're only allowed water? Because you're also banning juice and milk
with they ban.

~~~
manmal
That would be a good thing. Milk consumption greatly reduces iron absorption
(and health benefits are iffy to say the least), and fruit is better eaten
than drank. Our digestive system is built on the idea of chewing food (through
vagus nerve stimulation).

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_bxg1
It'd be much harder than cigarettes to define and enforce, and more prone to
loopholes. What's a "sugary food"? Grams of sugar? They'd just sell fun-sized.
Percentage mass? That could impact fruit. Added sugar? What is "non-added
sugar"? Specific product categories like soda and candy? They'd just walk the
line with things like "sweetened sparkling water".

I support the idea in principle, and I hope they figure out a way to define
it, but it'll be hard.

~~~
zanny
If I eat a strawberry thats non-added sugar. If I sprinkle sugar on the
strawberry, thats added sugar.

It would be pretty easy to deduce the distinction between added and not sugars
- if you put a sugar in your food and list it in the ingredients it has added
sugar. If the thing as its grown has sugar then its not an added sugar.

If that leads to the GMO modification of crops even further to produce more
sugars thats a lot less harmful than the status quo adding of corn syrup /
cane sugar / etc to everything.

~~~
novok
Any dish that is a prepared composite will quickly get into gray areas.

“I didn’t add sugar, i just put this highly sweet blended fruit in the dish!”

~~~
rsanek
The new version of the nutrition label specifically calls out added sugars
[1], so it sounds like if there are gray areas the FDA has been able to decide
on a standard.

[1]
[https://healthcare.utah.edu/healthfeed/postings/2018/05/nutr...](https://healthcare.utah.edu/healthfeed/postings/2018/05/nutrition-
labels.php)

~~~
Spivak
Right, but right now there's not a super strong incentive for companies to try
and manipulate their added sugar label. It can be a marketing thing for some
brands but if added sugar was actively penalized then you would start seeing
better attempts to keep foods sweet with "non-sugar" sources.

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paulcarroty
And sitting without physical activity too, please, it's much more dangerous.

~~~
teamski
Exercise is important especially for your brain but bad nutrition has a much
higher impact than no exercise.

~~~
buzzerbetrayed
Out of curiosity, how did you become so knowledgeable about nutrition? This
comment, and your other (now deleted) comment make it seem like you are really
confident that you know more than everyone else.

My biggest complaint about learning about nutrition is that everyone says
opposing things, and it is really difficult for me to know what is right and
what is snake oil.

Any tips on learning the “right” way to be healthy?

~~~
Mirioron
I would recommend getting a variety of sources of information while staying
very skeptical of any outlandish claims. However, the reason why diet is more
important than exercise is that exercise doesn't burn many calories compared
to how many calories you need for your body's upkeep during a day.[0]

Look at those numbers and keep in mind that a daily recommended caloric intake
is at 2000 kcal. Now look at caloric values of food - carbs and protein are at
around 4 kcal per gram and fat is 9 kcal per gram. Take pineapple juice for
instance - it has around 60 kcal per 100 ml. If you drink 2 glasses of that
(400ml) then that's already more than 10% of your daily calories. People often
drink an entire liter per day though.

[0] [https://www.health.harvard.edu/diet-and-weight-
loss/calories...](https://www.health.harvard.edu/diet-and-weight-
loss/calories-burned-in-30-minutes-of-leisure-and-routine-activities)

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RandomInteger4
No, it's not. This is ridiculous.

Sugar is bad in large quantities, but there's no such thing as second hand
sugar consumption, which is the main reason why anybody wanted to regulate
smoking, since nobody wants to get lung cancer from working in a place where
everyone else is doing something harmful.

What we need to do with regard to sugar is get people to have some got dang
self control, which starts with proper education K-12 and decent menus for
school lunches.

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s33n
Is there much difference between sugar and refined carbs like white bread?

~~~
conceptme
No the body will convert all sugars / carbs the same. The only difference is
how fast it will get in your blood.

~~~
will_brown
Not all sugar is actually processed by the body the same though.

Fructose gets processed in the liver whereas glucose goes into the blood
stream triggering insulin response.

Other very fine points are glycemic index, for example a low glycemic index
food breakdown to glucose, bypassing the liver, but is absorbed into the
bloodstream relatively slowly for glucose and minimizes the insulin
spike/response promoting more stable blood sugar levels.

~~~
conceptme
Yes that's definitely true I meant they will end up as the same end result.
The fast sugars will end up causing you want more of it again in a shorter
amount of time so it is ofcourse better to eat veggies instead of a candy bar
to get your required energy.

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kyriakos
Start by moving sugary products away from children. Also banning shops selling
sweets near the cashier.

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scythe
I think a smaller but still effective first step would be to label sugary
products as such. Many people may be unaware of the number of things they
consume which are more than 50% refined sugar by dry weight. A great deal of
"fruit" products fall in to this category.

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elil17
Should we trust the government to decide what food is “healthy”? Absolutely
not. Just look at how many times the “recommenced diet” has changed in the
past few decades. There’s no reason to expect that the current evidence
against sugar is more correct than previous (now debunked) evidence against
fat.

What’s more, what’s healthy depends on who you are. People with eating
disorders, for example, need easy access to caloric foods, including sugary
foods, to weight restore and eat healthily.

Instead of focusing on trying to figure out what is and isn’t good for you, we
should focus on making sure people have access to foods we already know are
healthy by eliminating urban food deserts.

~~~
tomjen3
Eating disorders can be some of the most dangerous things you can suffer from
(anorexia has a mortality of 30% if I remember correctly); however on a
population scale the damage is dwafted buy the damage from obesity because so
many more people are seriously fat.

~~~
elil17
Right, so there needs to be solutions that work for everyone. That’s why I
think food _access_ is key (i.e. more grocery stores in low income
neighborhoods). People who need more food can get it, and people who need
healthier food will have access.

~~~
tomjen3
That assumes that people will choose healthier food when it is available.

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nv-vn
How about we just let people choose what to do with their body?

As a kid my parents didn't care too much about what I ate. I regularly had
sweets of any kind as a kid. I certainly have no addiction to sugar because of
that. I probably drink soda less than once a month and have cake/ice
cream/chocolate/candy at about the same frequency. Meanwhile, people I grew up
with who were never allowed sugar seem much more addicted to it, eating sweets
with every meal or as a snack. Earlier this week I heard someone at work
talking about how their child has never eaten any kind of sweets before and
personally this just sounds like a recipe for disaster.

~~~
JMTQp8lwXL
The problem with this approach is, the vast majority of people pick the
default option when presented with it (e.g., states that, by default, mark you
as an organ donor have proportionally more organ donors).

Public policy has real, measurable implications. We don't need to treat sugar
like smoking or alcohol, but when you find a way to move people away from it
as their "default" setting, you will find, in aggregate huge savings in health
care expenses and better outcomes (a sizable amount of health care spending is
due to preventable conditions, like Type II diabetes).

I agree, in principle, people can still consume sugar, if they want. The
occasional slice of birthday cake is _not_ the problem with sugar. It's the
consumption of a 2-liter of soda, multiple times per week, that's the problem
(regular consumption). But we need to make it easier for people to avoid
processed, simple carbohydrates.

One possible solution is increasing the ubiquity and ease-of-access to whole
foods. Eating healthy needs to have the convenience of going to a fast food
restaurant -- they're everywhere, they're cheap, and it's fast. We desperately
need this as a society. Consider it more as a preventative, or we can pay for
it on the other end (higher health care costs).

~~~
nv-vn
I do agree with you that access to cheap/convenient healthy foods is certainly
lacking. This is definitely a problem I think we can and should tackle. I
think giving people more choices is a great thing and I would happily support
this. The "default" also makes a lot of sense here. Really at the end of the
day what I'm skeptical of is trying to force people's hands into cutting sugar
out of their diet.

~~~
JMTQp8lwXL
There's varying degrees of "force". For example, we could "force" people to
get their children vaccination, but that panders to fears of conspiracy
theories. Instead, you can take away access to public education (e.g.,
vaccination mandatory for schooling). Then it comes at a steep price, yet you
still maintain the freedom of choice. I don't think of vaccination as an
analogous example here, since nobody really sees sugar as dangerous. In small
quantities, it isn't. The danger is the context of the overall diet. Decades
of lots of sugar consumption undoubtedly leads to negative health outcomes.

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josteink
In my younger, smoking years, when the anti-smoking lobby grew stronger and
managed to land more and more restrictions on smoking, to the degree that you
almost felt like a leper...

I remember telling my anti-smoking, chocolate-eating friends “you know one day
they will come for you too, right?”

That sure didn’t take long. Let’s see how _they_ feel about it this time
around.

~~~
ricardobeat
Did you not eat chocolate? Did all of your anti-smoking friends had the urge
to eat chocolate during breaks or social events? That’s a very odd
characterization.

Smoking is banned for under 18 already, and affects others around you, while
chocolate does not (an I really saying this?). As seen in the article, sugar
is a bigger issue for the 4-18 age range. I’m sure your friends feel
absolutely fine.

~~~
josteink
> Did you not eat chocolate?

No. I don’t eat chocolate, don’t drink soda and don’t have sugar in my coffee.

You may find that crazy, but what’s really crazy is having no vices at all.

Trying to ban them all is sure to make us all unhappy.

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darkpuma
That's simply not going to happen because there is no "second hand sugar"
scenario. Even alcohol, which is incredibly destructive to third parties by
any measure (domestic abuse, drunk driving, etc), hasn't successfully been
publicly vilified to the same extent as smoking.

~~~
philwelch
It was, back in the 1920's.

~~~
zanny
It was a moral panic though, rather than a reflection on the legitimate bodily
harm of consumption. The prohibitionists were not arguing to save alcoholics
livers, they were arguing to ban perceived unchristian behavior.

~~~
philwelch
Domestic abuse was a large part of it; the temperance movement was largely and
at times primarily comprised of women, and the temperance movement was closely
linked to the women's suffrage movement.

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kazinator
I'm not harmed if I'm sitting next to a someone who is consuming sugar.

What we should have is health insurance premiums based on risk factors such as
obesity, even in public systems.

~~~
rootusrootus
That could get exciting. Think of all the factors we could base health
insurance on. Risky outdoor activities? Higher premiums. Biking to work?
Higher premiums.

Alternatively, we could work to help everyone become healthier, and then use
as large a risk pool as possible to leverage the benefits of insurance.

~~~
beatgammit
Well, life insurance does that. I recall having someone over to check my
health and they had me fill out a form detailing the types of activities I do
(it even covered skydiving).

Since I'm healthy, I got a fantastic rate.

However, nothing like that happened for my health insurance. The closest I
have is a program that helps pay for my gym membership if I go regularly. The
really silly thing is that I'm not able to go regularly because I ride my bike
a lot, yet I am likely more healthy because of that than many of the people
who go to the gym regularly.

Honestly, I would totally be down with a voluntary system like that for things
like obesity, smoking, etc. If I present a lower risk to the insurance
company, shouldn't I be rewarded with lower rates? If that were the case, I
think more people would make real changes to their lives instead of fiddling
with fad diets, pedometers, and gym memberships. Saving $20/month on a gym
membership or getting a free Fitbit is less motivating than saving $100/month
for being healthy.

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haunter
Social media is the new smoking not sugar

~~~
buboard
Hacker news is my new smoking

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zzo38computer
Smoking has second hand smoke, but I think sugar is internal to your body
rather than all everywhere like smoking is. So, it is not same kind of thing
and should not be treat like same kind of thing, due to that.

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dfilppi
No unless second hand sugar is a thing.

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sureaboutthis
I have a feeling most of the addiction came from the food and drink industry.
Perhaps the amount of sugar contained in the industry provided foods should be
restricted to some sane amount and not a quantity to induce you to eat it.
This way, the home cook can control their sugar intake and the home cook
cannot produce the number of available goods one eats by just picking it off
the shelf at a store.

Higher end restaurants that cook their own food won't be restricted this way
either and that's a good thing because one goes to such places for food you
don't normally get at home but fast food restaurants get most of their food
from factory stores where sugar content can and should be restricted for the
same reason grocery store food should--sweetening foods makes you want them
more.

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pfdietz
Yet another application of Betteridge's Law of Headlines.

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teamski
haha deleted

~~~
ddorian43
So you're on keto ?

~~~
cuddlecake
I think keto is even lower on carbs. At most 20-30g per day (only nuts and
vegetables, basically).

But, obviously, like 99% of people, the parent poster lacks the willpower to
do that. _wink wink_

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nipponese
While we're on the topic of telling people how to live, why don't we keep the
sugar and simply start exercising?

~~~
rootusrootus
You can't outrun the spoon.

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stillbourne
What? No! Fucking hell. Speak to a nutritionist. You need carbs! They aren't
bad when eaten in the correct amount and type. The body uses glycogen and
glucose for energy, the problem isn't sugar, the problem is a lack of
understanding by the public on the topics of exercise, food and health. I
don't know about anyone else but all three school types (private, public, and
charter) in America seem to neglect this type of information when teaching PE.
We seem to treat PE as strictly a means to burn off excess energy for
overactive adolescents instead of using this as an opportunity to understand
the biological mechanisms involved in converting food to fuel. That is not to
say that this information is not taught but it seems that its only ever taught
as an extracurricular when a student picks up a sport such as football. Even
then its almost treated like tribal knowledge passed down from the coach to
the players.

All of this is further hampered by other factors as well such as the
disappearing HomeEc curriculum, the general faddness of dieting in the press
(this article being a good example) and a misconception on the behalf of the
public on matters related to food consumption. There is almost a
mysticism/dogma about how food works that seems to prevail over discourse
related to nutrition these days. Furthermore, there is a return to quackery
lately with things such as alkaline diets and such despite the fact that most
of the foods that they suggest to eat, such as fruit, are often more acidic
rather than basic. I blame this on MLMs trying to sell water to middle class
retards too stupid to understand that they are being swindled. Sugar is not
the Great Satan of food. It's simply people that are too ignorant to
understand what they are eating will continue to make poor choices.

