• 56-names-of-sugar
    Figure 1: 56 Names for Sugar (Click to Expand) (Porterfit, 2015) Used with permission.

    By Julie Omsberg, RN, BSN, MNEd
    Kaplan University Faculty

    The truth is, sugar is a public health concern, a fact most nurses are blissfully uninformed about. Sure, we all know sugar isn't good for you, but many nurses are unaware that scientific date proves sugar is toxic and largely responsible for the childhood obesity epidemic (Lustig, 2014). 

    Sugar has many names—56 in fact (Figure 1). It is highly addictive, inducing cravings that are comparable in magnitude to those induced by addictive drugs (Ahmed, Guillem, & Vandaele, 2013). 

    Sugar Consumption and Health Risks

    global sugar
    Figure 2: The Global Sugar Glut. Reprinted by permission from Macmillan Publishers Ltd: [Nature Magazine] (Lustig, R. H., Schmidt, L.A. & Brindis, C.B. (2012). The toxic truth about sugar. Nature. 482 (27-29). doi:10.1038/482027a)

    In addition to sugar's addictive nature, it interferes with our appetites and creates an insatiable desire to eat. Whatever you call it, sugar has caused the rate of obesity and the diseases associated with it to increase at an alarming rate (Lustig, 2015).

    According to scientists, sugar consumption causes metabolic syndrome (Lustig, 2014; Lustig, Schmidt & Brindis, 2012). Metabolic syndrome is a cluster of health risks that include diabetes, hypertension, inflammation, cancer, hyperlipidemia, non-alcoholic fatty liver disease, and cardiovascular disease (NIH, 2015). Figure 2 illustrates the excessive rate the United States is consuming sugar (Lustig, Schmidt & Brindis, 2012).

    Emergence of High Fructose Corn Syrup

    NU - Obesity and HFCS
    Figure 3: HFCS & Obsesity 1976-2000 (Click to Expand) (Porterfit, 2015)

    In 1970, companies started producing sugar from corn. As a result, high fructose corn syrup (HFCS) emerged, and as our usage of HFCS has increased, so has our obesity rate (Figure 3). Its concurrent rise with obesity is compelling. HFCS is extremely inexpensive to make and tastes good, yet causes spikes in blood glucose, triggering the release of insulin. Insulin is the fat storage hormone and immediately stores the increased, yet metabolically unnecessary, glucose in the blood as fat (Lustig, 2014). 

    As evidence has been compiled, we now know reducing sugar (especially liquid sugar), from infancy is the most direct route to a healthy child. "Obese children and adolescents report significant impairment in all domains-physical, psychosocial, emotional, social and school functioning" (Schwimmer, Burwinkle & Varni, 2003).

    Rising Obesity Rates and Sugar

    CDC Obesity Map
    Figure 4: CDC Obesity Maps 1986-2009 (Click to Expand)

    The Centers for Disease Control have been tracking obesity rates since 1986. The rate of obesity in the USA has exploded during this time period. In 1986, only seven states had obesity rates over 14%. By 2009 all 50 states had obesity rates above 14%, and 9 states had rates over 30%. (Figure 4, CDC, 2015). 

    How did this happen in less than 30 years? According to Dr. Lustig, "it's the sugar…it's killing us slowly and I'll prove it" (Lustig, 2013, p. 30). Our national obesity rate is now over 35% in 33 states (see Figure 5 [CDC, 2015]). 

     In 1972 John Yudkin, a British physiologist and nutritionist, exposed the dangers of sugar in his book Pure, White and Deadly (Yudkin, 1972). He is now considered prophetic, as his warnings about the harmful effects of sugar have transpired exactly as he predicted. Before metabolic syndrome was researched, Dr. Yudkin came to the conclusion that sugar needed to be regarded as a poison. His book left him ostracized and criticized by the medical community; he died before his work became accepted and he became regarded as a visionary.

    CDC Obesity Map 2014
    Figure 5: CDC Obesity Map 2009 (Click to Expand)

    Dr. Robert Lustig, a pediatric endocrinologist at University of California San Francisco (UCSF) states, "everything this man said in 1972 was the God's honest truth and if you want to read a true prophecy you find this book …(it) helps us understand how a concept can be bastardised by dark forces of industry" (Smith, 2014, para 7). Dr. Lustig is credited with starting the anti-sugar movement when his lecture at UCSF, "Sugar: The Bitter Truth," got over 4 million views on YouTube (Lustig, 2009).

    Recognizing what happened to Dr. Yudkin's findings illustrates the food industry's deliberate deception of the truth about the toxicity of sugar-taking a page from the tobacco industry and doing everything necessary to promote their product while hiding harmful facts by funding their own "research." The food industry could not let the facts about sugar be known because it would kill their profits. According to National Geographic (2014) some in the industry secretly devised a plan to conceal the truth (2014).


    If you are reading this article as a nurse or a nursing student and you did not know:

    • what metabolic syndrome is;
    • the correlation between obesity, diabetes, and sugar intake;
    • that sugar is the most significant cause of childhood obesity;
    • and that an overwhelming number of children who are obese will remain obese for their whole lives,

    I have served my purpose (Lustig, 2014). As nurses, we must understand, recognize, diagnose, prevent, treat, advise, and most of all, help and care for populations at risk. To combat this serious public health concern, we must learn the truth about sugar and integrate these facts into nursing education.



    Julie Omsberg, RN, BSN, MSNEd, is a faculty member at Kaplan University. The views expressed in this article are solely those of the author and do not represent the view of Kaplan University.

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  • References

    Ahmed, S., Guillem, K., & Vandaele, Y. (2013). Sugar addiction. Current Opinion in Clinical Nutrition and Metabolic Care, 434-439.

    Centers for Disease Control (2015). Obesity prevalence maps. Retrieved from: http://www.cdc.gov/obesity/data/prevalence-maps.html

    Lustig, R.H. (2009). Sugar: The bitter truth. Retrieved from: https://youtu.be/dBnniua6-oM

    Lustig, R. H., Schmidt, L.A. & Brindis, C.B. (2012). The toxic truth about sugar. Nature. 482 (27-29). doi:10.1038/482027a

    Lustig, R.H. (2014). Fat chance. New York, New York: Hudson Street Press

    National Geographic (2015). Secrets of sugar - the fifth estate. Retrieved from: https://www.youtube.com/watch?v=-8eQ_8Jogcw

    National Institute of Health (2015). What causes metabolic syndrome? Retrieved from: http://www.nhlbi.nih.gov/health/health-topics/topics/ms/causes

    Porterfit, M. (2015). Nutrition: Real Talk. The 56 names for sugar. Retrieved from: http://michelleporterfit.com/2015/7/2/56-different-names-for-sugar

    Schwimmer,J.B., Burwinkle, T.M. & Varni, J.W. (2003). Health-related quality of life of severely obese children and adolescents. Journal of American Medicine. 289(14):1813-1819. DOI: 10.1001/jama.289.14.1813

    Smith, J.L. (2014). John Yudkin: the man who tried to warn us about sugar. The Telegraph. Retrieved from: http://www.telegraph.co.uk/lifestyle/wellbeing/diet/10634081/John-Yudkin-the-man-who-tried-to-warn-us-about-sugar.html

    Yudkin, J. (1972). Pure, white and deadly: How sugar is killing us and what we can do about it. London, England: Davis-Poynter


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