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UCSF Dr. Robert Lustig at Highland Hospital in Oakland, Calif. before giving a presentation about his research on sugar and the obesity epidemic facing this country on Friday, April 29, 2011. (Laura A. Oda/Staff)

An academic lecture that lasts nearly 90 minutes usually will get about a million yawns and, if lucky, a hundred hits on YouTube.

But a recently discovered talk by a Bay Area doctor with a fresh take on the obesity epidemic recently rocketed the YouTube video to viral status. Supporting the thesis that sugar is nothing short of "poison," Dr. Robert Lustig, a professor of clinical pediatrics in the division of endocrinology at UCSF, clearly has hit a nerve. And his no-nonsense message about health and sugar is spreading through media channels like wildfire.

The U.S. will not get a handle on the obesity epidemic, Lustig says, if the public continues to view obesity as the result of gluttony and sloth. No one chooses to be fat, especially not the thousands of babies and toddlers in the United States who are obese or at risk for it. That's why obesity should be seen as a public health crisis on the level of AIDS rather than a personal responsibility issue, he argues.

"(AIDS) initially was thought to be everybody else's problem," Lustig says. Eventually, public policy turned the AIDS epidemic into a public health concern that all people should be aware of and protect themselves against, he says. Research and education policy followed.


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A powerful public speaker, Lustig is getting a not-undeserved reputation as an anti-sugar activist. He frequently calls sugar "poison" and a "toxin" and his 2009 UCSF lecture on the subject recently went viral on YouTube with more than 1.2 million views. The speech makes the case that Americans fill their diets with sugar now more than ever. Our addiction to sugar may be a main reason for the obesity epidemic and, in turn, growing incidences of heart disease, diabetes and some forms of cancer, among many other problems.

"We have to understand what's causing obesity. We couldn't do anything about AIDS until we understood what caused it," he says. The most recent data from the Centers for Disease Control and Prevention indicates that more than 30 percent of men and women in the U.S. are obese and many more are overweight.

Lustig's thoughts on sugar -- both fructose and sucrose -- and obesity are getting the attention of noted health experts and journalists, including journalist Gary Taubes, author of the best-selling book "Why We Get Fat: And What to Do About It" (Knopf, $24.95). In Taubes' April 13 article in the New York Times Magazine, he says Lustig's argument that sugar is a harmful chemical is worth further evaluation even if it his statements are controversial and not totally supported by all health experts and diet researchers.

Fitness expert and author Alan Aragon, for example, argues that Lustig has a "myopic, militant focus on fructose avoidance" and argues for a caloric balance instead of avoiding sugar altogether.

Numbers are too high

One thing is certain, though: Lustig is correct about Americans' increasing sugar load. Marisa Moore, a registered and licensed dietitian and spokeswoman for the American Dietetic Association, says most Americans are getting 22 teaspoons of added sugar per day. "Added sugar" is basically sugar not found naturally in fruits, vegetables and milk. Experts recommend only 6 to 9 teaspoons of added sugar per day.

"At 22 teaspoons, that's about 350 calories extra per day which can lead to as much as three pounds of weight gain per year," she says. After it's consumed, sugar turns into glucose and when the liver processes excess glucose, it is turned into fat.

And, like Lustig, Moore doesn't differentiate between white sugar -- sucrose -- and the demonized high-fructose corn syrup when she's talking about excessive sugar consumption.

"There is not a preference for one over the other," she says.

One reason we're consuming so much sugar, Lustig says, is because in the 1980s, public health officials suggested a lower fat diet to minimize the risk of heart disease.

He points to the Snackwells brand of cookies and sweets. Produced by Nabisco, the treats are known to be lower fat alternatives. But in order to taste good, Lusting says, they are loaded with sugar.

In fact, many products that are labeled "low fat" have added sugars, he says. Why? Because without the fat and sugar the food would "taste like cardboard."

"As far as I am concerned," Lustig recently told doctors at Highland Hospital in Oakland, "our food has been adulterated."

We are also being overloaded with sugar in some of the drinks we consume. Regular sodas are full of several servings of sugar, as are specialty coffee drinks and fruit juices.

Alameda County Health Department nutrition services director Diane Woloshin calls Lustig a "pioneer" in his effort to bring more attention to sugar's role in obesity and praises his research into the correlation between what we drink and how fat we're becoming as a nation.

Call for more research

"The studies are now showing that for every serving of sweetened beverages consumed, the risk of becoming overweight increases remarkably," she says. It's a political issue too, she says, because the beverage industry is a strong advertiser and hires lobbyists to protect access to, for example, schools.

"It's definitely a public health issue and that's behind some of our efforts to remove sodas from schools and change policies," Woloshin says.

Although Lustig is an in-demand speaker right now, he has made it clear that he has no dreams to be Dr. Phil. He's not writing a book or going on tour to tout weight loss strategies. Instead, he says he ringing the alarm that there can be several reasons Americans of every age are obese and overweight other than just gluttony and sloth.

"The concept of obesity being personal responsibility is something I think has been a major problem in (the field of medicine)," he says.

Environmental toxins

Sugar isn't the only culprit Lustig blames for the obesity epidemic. During the recent Highland Hospital lecture, Lustig also suggests that, based on studies on lab rats, exposure to environmental toxins such as Bisphenol A, used to make plastics, certain insecticides and fungicides, could also be contributors to obesity in adults and children. The animal studies -- some in which show rats grow fatter than their non-exposed counterparts after being exposed to toxins both in utero and out -- don't prove exposure to fungicides, for example, cause obesity. But Lustig says there is a correlation. Toxins, along with our food production industry, should be explored further to get to the bottom of the alarming obesity health crisis, he says.

Lustig adds that public policy -- like keeping sugary drinks out of schools -- and recognition by physicians that obesity can have several causes, is a way to start addressing this problem.

"This is a major public health issue, and it doesn't have an easy solution," Lustig says.