Regulating products based on a scientifically-based risk analysis is a worthy goal. Lustig et al (Nature 482, 27–29; 2012)., admirably make a bold case for such an approach. However, misplaced comparisons between sugar and alcohol detracted from the salience of the article in contemporary regulatory debates. Carbohydrates are essential energy sources which humans have evolved to metabolize, including fructose which is found in fruits and berries that hunter-gatherers frequented. Even highly concentrated forms of these energy sources were found naturally in some of the most resource-scare environs -- notably dates (Phoenix dactylifera) in deserts. Indeed, desert-dwellers consumed large quantities of dates as energy sources with little documented health impacts (Al-Farsi, Mohamed Ali, and Chang Yong Lee. 2008. “Nutritional and Functional Properties of Dates: A Review.” Critical Reviews in Food Science and Nutrition 48 (10): 877-887).
Unlike alcohol, sugars do not cause behavioral intoxication, nor do they have the second-hand proximity impact of tobacco smoking -- key motivators for their regulation. The authors downplay complex factors which have led to noncommunicable disease burdens such as changes in exercise patterns; additional chemical additives; endocrine disruptors in the environment that impact metabolic activities; and most significantly longer life expectancy!( Beaglehole, R, and D Yach. 2003. “Globalisation and the Prevention and Control of Non-communicable Disease: The Neglected Chronic Diseases of Adults.” The Lancet 362 (9387) (September 13)). To simplify such vast complexity into a "toxic truth" about refined carbohydrates is highly problematic. The authors would serve the cause of public health far better to present a more systemic and nuanced approach to managing a balanced diet with exercise rather than demonizing sugar.