Ask most people how they feel about grocery shopping, and they may talk about the supermarket they'll never set foot into, where it smells bad and the produce looks pitiful, or the sunny one with nice cuts of meat and good prices on children's cereal. But to Robert Lustig, a professor of clinical pediatrics at the University of California, San Francisco School of Medicine, the supermarket is something else entirely. It's ground zero in the fight for your life, where decisions between plain or flavored Greek yogurt, oranges or orange juice, and red kidney beans or Bush's Grillin' Beans mean the difference between sickness and health.
The last 30 years have seen an onslaught of sugar and dwindling of fiber in the food environment, a deadly combination for consumers who have been duped by the food industry, Lustig argues. He sounded this battle cry in his 2009 lecture, "Sugar: The Bitter Truth," which became a viral hit with nearly 4 million views on YouTube, and in his 2012 book, "Fat Chance: Beating the Odds Against Sugar, Processed Food, Obesity and Disease."
Now, he's putting his message in more practical terms, offering consumers a handbook for the supermarket with "Sugar Has 56 Names: A Shopper's Guide." An e-book that's meant to travel with shoppers on their smartphones or tablets, the guide, released this month, provides consumers with a new nutrition label for hundreds of processed foods that puts the spotlight on where it should be, he argues: sugar. From soy milk to sausage, and Sara Lee to supermarket brands, the data delineates the quality and quantity of sugar in products. Why the distinction? Because, as the book's title indicates, sugar goes by varied names - from fructose to fruit juice, and these derivatives differ greatly in how they're processed by the body.
"By paying attention to the sugar portion of the label people can do better in terms of making their own decisions," Lustig says. The current nutrition label falls far short of that, he says, noting that the label lacks a percent daily value for sugar, which makes it difficult for people to calculate how much is too much.
Meanwhile, added sugar has crept into the food supply in everything from bread to barbecue sauce, and often the ingredients are cloaked in curious names and orders. For example, products list ingredients according to quantity, but a product might include various forms of sugar as its fifth through ninth ingredients, which, when added together, render sugar worthy of the first listing. But by reading a nutrition label, you can't distinguish between a food's inherent and added sugar, the behemoth between you and good health.
At stake, Lustig argues, is less the issue of obesity than the risk of metabolic diseases, which includes diabetes, heart disease, fatty liver disease, cancer and dementia. And sugar, he says, is a big part of the problem.
More details about the interaction of food substances on our physiology are provided in the book - he also has a low-sugar, high-fiber cookbook slated for release next year - but he leaves readers with some overarching directives, like these six tips: don't go to the supermarket hungry; shop along the perimeter of the supermarket where fresh, whole foods abound; if it comes with a logo you've heard of, it's been processed; avoid anything "partially hydrogenated" ("it will outlive you," he writes); just because it says "whole grain" doesn't mean it is, but if it doesn't say whole grain it isn't; if sugar is listed among the first three ingredients, it's dessert.
What else? Start your supper with a salad free of sugary dressing to fill up on fiber-rich food. Skip the cereal and granola bars and make a fast, healthy breakfast by scrambling eggs or frying some bacon the night before. Let your kids pack their (dessert-free) lunch with items they choose so they're more likely to eat it.
For his part, there's "no such thing as a sugared beverage" in his home. "We have milk, we have water and occasionally we have some alcoholic drinks when we have friends over," he says. "There is no reason to drink your calories." To ensure sufficient fiber, the Lustigs have salad with every meal, which typically consists of a protein and green vegetables and whole-grain bread instead of white rice, pasta and potatoes. For dessert, it's whole fruit, except for weekends, when they treat their daughters, ages 8 and 14, to something "a little more elaborate," he says.
"We have to get back to dessert being once a week, not once a meal," Lustig says. As he writes, "Sugar is reward. Sugar is fun, but if every meal is fun, then no meal is fun. And I promise, you won't be having fun taking your insulin shots while you're on dialysis."
To change the food culture, and the food supply, he encourages consumers to vote with their mouths and wallets. "We, as a society, have to reduce availability, and we cannot do that right now without the food industry helping us do it," he says. "If you won't buy it, they won't sell it."
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