Killing them sweetly

One of my Somali patients once told me a crazy story she heard in the refugee camps in Kenya. In America, the story went, some people eat so much they grow to enormous size – three or four times as large as regular people. They get so big they can't even walk. Of course, she never believed it for a second.

Then, a few weeks after she moved here, someone took her to Costco. There, on a breakfast cereal aisle that looked like a canyon of brightly-colored boxes, she saw a 400-pound man driving through the store on a scooter. She described it as if she'd seen Bigfoot.

Our country is not like the rest of the world. Fully 30 percent of American adults are obese. Metabolic syndrome – the deadly combination of elevated blood sugar, blood pressure, cholesterol and weight – is almost epidemic here. We have one of the highest rates of diabetes in the world, and it more than doubled over the last thirty years.

Recent evidence points to one main culprit in all these trends: sugar.

Let me say right now that I've never been a food alarmist. I'm usually the first to point out that, although some kids have serious reactions to things like peanuts, or dairy, or gluten, those probably don't explain why Susie is failing algebra, or Johnny is biting kids at preschool. I don't recommend food restrictions unless there's a clear medical need.

This is a clear medical need.

I'm not sure sugar should even be considered food. Sure, it's derived from nature, and people have been consuming it for a long time. But the same can be said for nicotine and alcohol – or for that matter, opium and cocaine. It turns out that sugar has a lot in common with all of those drugs. It's a highly refined, purified substance that only became widely available when ambitious merchants found a way to mass produce it to exploit a growing demand. And that demand has the same roots as for any addictive substance: People literally can't get enough.

Before we go deeper into the science of sugar, let's debunk the one thing most parents think they know about it. Sugar does NOT make your kids hyper. At least a dozen double-blind, placebo-controlled studies have failed to show any evidence that sugar causes hyperactive behavior. Why then, you ask, do so many parents swear that it does?

Gee, I don't know. If you take a roomful of 4-year-olds, surround them with balloons and presents, and give them endless supplies of ice cream and cake, why in the world do they seem so excited? Who would've guessed? But don't let the whole "sugar-buzz" debate distract us. There are far greater dangers lurking in the sugar bowl.

Let's imagine two pre-historic parents watching their kid eat berries on a late autumn afternoon. Do you think they were worried that she might put on weight and develop self-esteem problems? No! They were worried that the snows would come early and they'd all starve to death.

Our ancestors evolved to turn the short-lived sweetness of ripened fruit into a hedge against the long, lean winter. The ones who survived were the ones who craved sugar, consumed it with abandon, and stored it in their bodies as fat. For most of human history, sugar has been a scarce and precious commodity. Even in the 1800s, the average American consumed only two pounds of sugar a year. Now that's ballooned to 150 pounds – and we've ballooned with it.

We crave sugar because our genes tell us to, and because it lights up our brain's pleasure centers like a pinball machine. Sugar goes to the liver and causes it to create, store and disperse fat. This damages blood vessels, stresses your pancreas, and makes your body resistant to insulin. The sudden sugar spike is followed by a crashing sugar low, which causes fatigue and inactivity. The net result? Obesity, diabetes, atherosclerosis and heart disease.

I'm not saying we should completely eliminate sugar from our kids' lives. But, as with any addictive substance, a little moderation is in order. There are 10 teaspoons of sugar in a can of soda pop. On average, Americans consume the sugar equivalent of 24 cans of pop a week. That's not like an occasional glass of wine with dinner. That's a fifth of vodka on the bedside table.

So the next time you see a morbidly obese person struggling to cross the street in front of you, or squeezing into the airplane seat beside you, try to withhold your judgment and scorn. It may be less their failure as individuals than it is our failure as a culture, and as parents.

And someday, if we aren't careful, that could be your kid.