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State of the debate: Global oral health and sugar

BDJ In Practice volume 37, pages 236–240 (2024)Cite this article

On May 26, 2009, Robert Lustig gave a lecture called ‘Sugar: The Bitter Truth,' which was posted on YouTube the following July, and has had 24 million views in the proceeding 15 years.1 In 2012, Lustig, along with Laura Schmidt and Claire Brindis authored a paper in the journal Nature entitled ‘The toxic truth about sugar'.2 In it they argued added sweeteners pose dangers to health that justify controlling them. That lecture, and subsequent published material, is where I've been able to trace the first mentions of the phrase ‘sugar is the new tobacco'.

Before addressing these questions, it's worth looking at the journey tobacco took itself on. Lung cancer was once so rare that doctors took ‘special notice when confronted with a case', Robert Proctor wrote, thinking it a once-in-a-lifetime oddity. Proctor went on to identify that: ‘Mechanisation and mass marketing towards the end of the 19th century popularised the cigarette habit, however, causing a global lung cancer epidemic. Cigarettes were recognised as the cause of the epidemic in the 1940s and 1950s, with the confluence of studies from epidemiology, animal experiments, cellular pathology and chemical analytics. Cigarette manufacturers disputed this evidence, as part of an orchestrated conspiracy to salvage cigarette sales. Propagandising the public proved successful, judging from secret tobacco industry measurements of the impact of denialist propaganda. As late as 1960 only one-third of all US doctors believed that the case against cigarettes had been established'.3

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References

  1. YouTube. Sugar: The bitter truth. 2009. Available at: www.youtube.com/watch?v=dBnniua6-oM (accessed July 2024).

  2. Lustig R, Schmidt L and Brindis C. The toxic truth about sugar. Nature 2012; 482: 27-29.

  3. Proctor R N. The history of the discovery of the cigarette-lung cancer link: evidentiary traditions, corporate denial, global toll. Tobacco Control 2012; 21: 87-91.

  4. U.S. Department of Health, Education, and Welfare [USDHEW]. 1964.

  5. European Environment Agency. Late lessons from early warnings: science, precaution, innovation. EEA Report No 1/2013. Available online at: www.eea.europa.eu/publications/late-lessons-2 (accessed July 2024).

  6. The Guardian. News release: Tobacco firms lobbying MPs to derail smoking phase-out, charity warns. 15 April, 2024. Available online at: www.theguardian.com/society/2024/apr/15/tobacco-firms-lobbying-mps-to-derail-smoking-phase-out-charity-warns (accessed July 2024).

  7. Kearns C E, Schmidt L A, Glantz S A. Sugar Industry and Coronary Heart Disease Research: A Historical Analysis of Internal Industry Documents. JAMA Intern Med 2016; 176: 1680-1685.

  8. Gornall J. Sugar: spinning a web of influence. BMJ 2015; 350: h231.

  9. World Health Organisation. Discussion paper: Draft Global Oral Health Action Plan 2023-2030). Available online at: https://cdn.who.int/media/docs/default-source/ncds/mnd/eb152-draft-global-oral-health-action-plan.pdf (accessed July 2024).

  10. Oral Health. Lancet 2019; 394: 10194.

  11. Global oral health status report. Towards universal health coverage for oral health by 2030. Available online at: www.who.int/team/noncommunicable-diseases/global-status-report-on-oral-health-2022 (accessed July 2024).

  12. FDI World Dental Federation. Vision 2030: Delivering Optimal Health for All. Available online at: www.fdiworlddental.org/sites/default/files/2021-02/Vision-2030-Delivering%20Optimal-Oral-Health-for-All_0.pdf (accessed July 2024).

  13. World Health Organisation. Draft Global Oral Health Action Plan (2023-2030). Available online at: www.who.int/publications/m/item/draft-global-oral-health-action-plan-(2023-2030) (accessed July 2024).

  14. Benzain H, Daar A and Naidoo S. Redefining the non-communicable disease framework to a 6 × 6 approach: incorporating oral diseases and sugars. Lancet Public Health 2023; 8: e899-904.

  15. Institute for Government. Sugar tax. Available online at: www.instituteforgovernment.org.uk/explainer/sugar-tax (accessed July 2024).

  16. World Cancer Research Fund International. Looking back at 5 years of the UK Soft Drinks Industry Levy. Available online at: www.wcrf.org/looking-back-at-5-years-of-the-uk-soft-drinks-industry-levy/ (accessed July 2024).

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    David Westgarth

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Westgarth, D. State of the debate: Global oral health and sugar. BDJ In Pract 37, 236–240 (2024). https://doi.org/10.1038/s41404-024-2800-0

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