Annals of Health Law
HOW TO REGULATE TOXIC FOODS
premise is that in order to maintain a healthy weight, we have to burn more
calories than we consume. Dr. Lustig’s theory refutes this premise; because
fructose is only metabolized by the liver, fructose calories are more likely
than calories from other sources to contribute to obesity. 49 As such, not all
calories are created equal. 50 A study by Dr. David Ludwig of Boston
Children’s Hospital confirms Dr. Lustig’s theory. 51 This is one of the
reasons for Mayor Bloomberg’s initiative to limit quantity sizes of sugar-laden beverages. 52 “Desserts and sodas and energy and sports drinks are the
top sources of added sugar in most American diets.” 53 Sugar adds calories
and fat, but no nutritional value to the diet. 54 This may help explain why
low-fat diets, which were promoted in the 1980s, failed to make a dent in
obesity rates. When fat was taken out of many foods, sugar was often
added to enhance taste. In fact, obesity rates since the 1980s have
skyrocketed. 55 While correlation does not prove causation, there is
substantial evidence that sugar is a primary factor in the current rates of
Sugar consumption is also implicated in diabetes, heart disease, and
hypertension, all of which are connected to metabolic syndrome. 56 The
liver, as the sole metabolizer of fructose, is critical in terms of insulin
production, the hormone used to regulate blood sugar. When we eat, we
produce insulin to keep blood sugar at normal levels. Glucose and fructose
consumption impact insulin production in different ways. When we
consume glucose, insulin production is stimulated, telling the brain when
we are full and when to stop eating. Fructose, however, does not stimulate
insulin upon entry. 57 Having the liver convert fructose to fat “apparently
28, 2003, available at http://www.who.int/bulletin/releases/2003/PR0803/en/.
49. Gary Taubes, What Really Makes us Fat, N. Y. Times, July 1, 2012, at 5, available at
50. See Gina Kolata, In Dieting, Magic Isn’t a Substitute for Science, N.Y. Times, July
10, 2012 (in conversation with Dr. Jules Hirsch, Dr. Hirsch believes that the idea that not all
calories are created equal in the obesity debate is an “illusion”).
51. See David Ludwig et al., Effects of Dietary Composition on Energy Expenditure
During Weight Loss Maintenance, 307 ( 24) JAMA 2627, 2634 (June 2012); Cara B.
Ebbeling, Ph.D. et al., A Randomized Trial of Sugar-Sweetened Beverages and Adolescent
Body Weight, 367 N. ENG. J. MED. 1407, 1407 (Oct. 11, 2012), available at
52. New York Plans Ban, supra note 2.
53. Added Sugar: Don’t Get Sabotaged by Sweeteners, MAYO CLINIC (Apr. 5, 2011),
54. See Taubes, supra note 1.
55. Barbara L. Atwell, Obesity, Public Health, and the Food Supply, 4 IND. HEALTH L.
REV., 3, 6 (2007).
56. Vasanti S. Malik et al., Sugar-Sweetened Beverages, Obesity, Type 2 Diabetes
Mellitus, and Cardiovascular Disease Risk, 121 CIRCULATION 1356, 1364 (2010).