Article on 'toxic' health hazards of sugar

Review from the Office of the Ombudsman | English Services

Summary

The review concerns a public complaint about a CBC.ca headline and article involving an American medical commentary in the journal Nature on the “toxic” health hazards of sugar. There was no policy violation of CBC Journalistic Standards and Practices.

CBC.ca reported February 1, 2012 on a commentary in the health and science journal Nature titled “Public health: The toxic truth about sugar” and subheadlined: “Added sweeteners pose dangers to health that justify controlling them like alcohol, argue Robert H. Lustig, Laura A. Schmidt and Claire D. Brindis.”

The CBC.ca report was headlined: “Tax ‘toxic' sugar, doctors urge” and subheadlined: “Age restriction for sugary drinks proposed.”

The three-page Nature commentary (only available through subscription or purchase) noted a link between sugar consumption and the rise in non-communicable disease. For the first time in history, the authors observed, such chronic non-communicable diseases as heart disease, cancer and diabetes posed a greater health burden worldwide than did infectious diseases.

The authors, doctors from the University of California San Francisco, argued that sugar's effects on the body can be similar to those of alcohol and they were particularly critical of the extent of added sugar to virtually all processed food.

“Nature made sugar hard to get; man made it easy,” they wrote. “In many parts of the world, people are consuming an average of more than 500 calories a day from added sugar alone.”

They added that a “growing body of epidemiological and mechanistic evidence argues that excessive sugar consumption affects human health beyond simply adding calories.”

They cited several impacts: high blood pressure, diabetes, liver damage, among other things.

Rather than focus on saturated fats and salt as the culprits in the worldwide health crisis, the authors argued for more attention on added sugar. They recommended control strategies and regulation to limit sugar intake.

The CBC.ca report said the researchers said “sugar is so toxic that it should be taxed and slapped with regulations like alcohol.”

The CBC report noted that researchers were arguing for taxes, controls on the locations and density of fast-food outlets and convenience stores near schools, and limits on sales during the school day or designating age limits for buying drinks with added sugar.

It said the researchers believed sugar met four public health criteria for regulation first applied to alcohol: pervasiveness in society, toxicity, potential for abuse and negative impact on society.

The CBC report said the American Beverage Association's response to the commentary was that there were drink and portion sizes “for every occasion and lifestyle” and that providing more options was a better solution than taking drinks away.

The report also featured Dr. Arya Sharma, scientific director of the Canadian Obesity Network, who noted there were several toxic substances, such as salt and trans fat, that affect health if people eat too much of them.

Sharma said it was not possible to distill the issues of obesity down to a question of sugar intake, that the discussion was valuable, but that no one knew what the unintended consequences of regulating sugar might be.

The complainant, Scott Foster, wrote February 1: “Sugar is not a toxin.” While the researchers indicated “added sugars” pose a health risk, “there is no suggestion by the researchers that sugar is toxic.”

Foster said the report violated CBC Journalistic Standards and Practices in their understanding and reflection of implications involving science reporting.

He said CBC “has decided to misrepresent this scientific study and to sensationalize an irresponsible claim that sugar is ‘toxic.' I think that this is inaccurate and promotes a biased opinion that the only way to address a health risk to those people who consume far too much food and sugars is to restrict its access to everyone.”

Esther Enkin, the executive editor of CBC News, wrote back February 9 to note the definition of “toxic” as “capable of causing injury or death, especially by a chemical means: poisonous.”

She acknowledged the authors focused on added sugars and that they pointed out that our ancestors only had sugar available for a few months a year as honey. She cited a passage in the commentary: “A little is not a problem, but a lot kills — slowly.”

She noted the authors discussed the toxicity of excessive sugar consumption and also looked at how the effects of fructose on the liver are similar to those of alcohol.

“In that light, to attribute the view that the researchers who wrote the article view sugar as ‘toxic' — their word and attributed to them in the headline — seems to be fair and accurate reflection of their position,” Enkin wrote.

Foster wrote back February 17 and said neither fructose sugar nor glucose was toxic and that the health problems arose from excessive consumption. “The key point is ‘too much' of anything can cause health problems. That does not justify declaring that ‘sugar' by itself is toxic, and the authors of the article were not as radical as the headline at CBC News.”

He noted that several foods would have toxic effects if taken excessively.

“Your headline (and your news story) was misleading,” he concluded.

Foster was asked by this Office if he was asking for a review of the matter. He wrote back March 13 to outline how the article and other CBC coverage contributed to an “alarmist” impression. He noted that a British Broadcasting Corporation online article did not use the word “toxic” in its report on the commentary. He asked for a review.

CBC Journalistic Standards and Practices call for clear, concise, accurate language in reporting.

On matters of science and health, the policy notes: “We take care to understand properly and reflect the true implications of medical or scientific study results that we obtain, especially those involving statistical data.”

It adds: “In matters of human health we will take particular care to avoid arousing unfounded hopes or fears in persons living with or close to those living with serious illnesses. We will also avoid suggesting unproven benefits or risks to health related to changes in habits of consumption of food or pharmaceutical products.”

Conclusion

It is worth noting that the Nature piece was a “commentary.” Typically these journal articles do not reveal any new research. They tend to feature summaries of existing research, calls for further research, or pleas for public policy action. They are an expression of opinion, slightly outside of the core of scientific work, and have a broad public and journalistic appeal because they leverage expertise into advocacy that intersects with the political.

There are several types of sugars, the most common being sucrose extracted from sugar cane or sugar beet, but the term is widely applied to also include glucose, fructose and corn syrups used in food. The Nature commentary authors do not make much distinction among them, so it was neither unfair nor inaccurate that CBC used the term broadly.

Typically, a headline captures the substance but not necessarily the detail of the report. The CBC.ca article headline — “Tax ‘toxic' sugar, doctors urge” — placed the operative word “toxic” inside a quote mark, a common journalistic technique to demonstrate that the word was attributable in this case to the authors. There were several references to toxicity in their commentary, so the headline was fair and properly attributed.

As for the complainant's criticism of the article itself, I think it reasonable to suggest that neither the commentary authors nor CBC News said that any amount of sugar had a toxic effect. Rather, a reasonable inference from the commentary and the CBC report was that people were consuming excessive amounts in various forms through food and beverages and that overindulgence was at the root of the health problems.

The report would have benefited from more background on the incremental health hazard of sugar. And there could have been better phrasing when CBC.ca reported the authors singled out sugar as the “true culprit” in disease. The authors identified it as a factor that deserved attention over the existing health and policy focus on saturated fat and salt intake, but it was a slight interpretation to term it the “true” problem.

I did not share the complainant's view that it would have been better to scrub the term “toxic” from the CBC.ca report, as did another media report. I believe that would have muted the central thrust of the commentary and negated the impact of its strong wording.

I found the report reasonably distilled the commentary and its recommendations, provided expert analysis, and carried an industry response. It did not raise a false fear. There was no violation of CBC Journalistic Standards and Practices.

Kirk LaPointe
CBC Ombudsman