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Consumers beware: What the tobacco and sugar industry have in common

June 2, 2019
A curious dental professional uncovered a trove of documents showing the sugar industry had attempted to downplay evidence that its products were harmful.
Karen Davis, BSDH, RDH

Most Americans today are aware of the inherent dangers of tobacco use. In fact, you have to be living under a rock if you haven’t noticed the No Smoking notices that are prolific in restaurants, airports, and sporting venues. All of these used to welcome smokers to openly indulge in their habit at the expense of nearby nonsmokers.

But this evolution to publicize the dangers of smoking, shift public opinion, and create laws to protect nonsmokers in public has been slow, in part due to the willingness of the tobacco industry to hide health-related studies and information early from consumers. Has the public been duped once again by big industry about the health concerns of added sugar in diets? One dentist believes we have, and she’s been diligent in her search for the facts.

What Cristin Kearns, DDS, learned at a CE program

So, what happens if something you hear from a speaker during a CE course doesn’t jive with science as you know it? If you are Cristin Kearns, DDS, you start digging for the facts. Several years ago, she attended a CE program about diabetes. She was surprised to see sweetened tea promoted as a healthy beverage for that patient population. She questioned the speaker, but she didn’t stop there. She began researching the impact of sugar on overall health.

What she uncovered looked oddly familiar—big industry influencing public opinion and even science to shift the focus away from potential health concerns so that profits flourished. The tobacco industry knew long before the general public about the health dangers of smoking and did a good job of covering it up. Dr. Kearns learned that the sugar industry had reason to be concerned about the overconsumption of sugar and cardiovascular health based on laboratory studies as early as the 1960s, but those studies were never completed.1

Instead, the Sugar Association hired Harvard University researchers to research and publish data implicating dietary fats and cholesterol, not sugar, as the culprits to cardiovascular disease. Once findings were published in the New England Journal of Medicine (NEJM) in 1967 and went viral, so to speak, the food and beverage industry became fixated on low-fat and low-cholesterol everything.1 Consumers loved it. People could still eat delectable sweets as long as they avoided dangerous saturated fats. That still influences many consumer dietary choices today.

Trickle-down effect

Following the NEJM publication implicating fat as the culprit of cardiovascular disease, physicians everywhere began directing their at-risk patients toward low-fat, high-carb diets to “protect their hearts.” As a result, waistlines, fatty liver disease, and incidence of type II diabetes have been on a staggering trajectory ever since.

Today, two-thirds of the American population (including many children) are either overweight or obese.2 Eighty percent to 90% of obese individuals suffer from fatty livers, which can lead to fibrosis and liver failure.3 One hundred million people in the US have diabetes or prediabetes, which increases the risk of cardiovascular disease.4 Ninety-one percent of adults ages 20 to 64 have had dental caries.5

As for the influence of low-fat diets on improving heart health, cardiovascular disease is still the leading cause of death in the US, and stroke remains the number one cause of disability.6 While each of these conditions is more complicated than overconsumption of refined sugar in our diets alone, one has to wonder what the health status of our population would be today if the Sugar Association had been forthright in following the science back in the 1960s. They could have done this instead of paying researchers to publish results that made it easy for the food and beverage industry to dump sugar in everything, from bread to spaghetti sauce to energy drinks and yogurts.

The American Heart Association weighs in

By 2009, the American Heart Association realized the health concerns related to overconsumption of sugar, and it published a statement urging Americans to slash their sugar consumption from 100 grams of added sugar daily to 24 grams for women and 36 grams for men.7 Sadly, that information did not capture the attention of most physicians, the media, or consumers. Most Americans don’t have any idea how much sugar they consume daily or what the AHA recommends.

Today, being health conscious for some Americans includes reduction or avoidance of sugary foods and beverages. But just like those who suffered while indulging in tobacco, much of the damage has already been done related to the overconsumption of sugar. It raises triglyceride levels, increases blood pressure, and contributes to weight gain and visceral fat accumulation.7

Time to act

What can you do? Start with yourself. Eat and drink within the AHA guidelines and teach your patients to do the same. But it won’t be easy. Tobacco is addicting, and there is plenty of anecdotal evidence that says sugar is too. Some science is connecting the dots of a similar addictive effect that sugar has on the brain.8 So the sooner you and your patients adopt a virtually sugarless lifestyle, except for perhaps those special occasions, the healthier your futures could be. Thank you Dr. Cristin Kearns for not taking what you heard at a CE course at face value. You uncovered a sleeping giant. Now, Americans need to tame that giant.

Author’s note: Cristin Kearns, DDS, is a professor at the University of California at San Francisco. Learn more at ucsf.edu.


1. Kavanaugh A. Sugar’s sick secrets. How Industry forces have manipulated the science to downplay the harm. SugarScienceBlog. https://www.ucsf.edu/news/2018/12/412916/sugars-sick-secrets-how-industry-forces-have-manipulated-science-downplay-harm. Published December 26, 2018. Accessed April 8, 2019.

2. Obesity and Overweight. The Centers for Disease Control and Prevention website. https://www.cdc.gov/nchs/fastats/obesity-overweight.htm. Published 2017. Accessed April 8, 2019.

3. Andronescu CI, Purcarea MR, Babes PA. Non-alcoholic fatty liver disease: Epidemiology, pathogenesis and therapeutic interventions. Journal of Medicine and Life. 2018;11:20-23.

4. New CDC report: More than 100 million people have diabetes or pre-diabetes – infographic. The Centers for Disease Control and Prevention website. https://www.cdc.gov/media/releases/2017/p0718-diabetes-report-infographic.html. Updated July 18, 2017. Accessed April 8, 2019.

5. Dye BA, Thornton-Evans G, Li X, Iafolla TJ. Dental caries and tooth loss in adults in the United States 2011–2012. The Centers for Disease Control and Prevention website. https://www.cdc.gov/nchs/products/databriefs/db197.htm. Published May 2015. Accessed April 8, 2019.

6. Heart Disease Facts. The Centers for Disease Control and Prevention website. https://www.cdc.gov/heartdisease/facts.htm. Updated November 28, 2017. Accessed April 8, 2019.

7. Johnson RK, Appel LJ, Brands M, et al. Dietary sugars intake and cardiovascular health. A scientific statement from the American Heart Association. Circulation. 2009;120:1011-1020.

8. Olszewski PK, Wood EL, Klockars A, Levin AS. Excessive consumption of sugar: An insatiable drive for reward. Current Nutrition Reports 2019. 1007/s13668-019-0770-5. [Epub ahead of print.]

Karen Davis, BSDH, RDH, is the founder of Cutting Edge Concepts, an international continuing education company, and practices dental hygiene in Dallas, Texas. She is an independent consultant to the Philips Corp., Periosciences, and Hu-Friedy/EMS. She can be reached at k[email protected].