Lustig's research examines links between excess consumption of fructose—a component of sucrose (table sugar), honey, fruit and some vegetables—and the development of metabolic syndrome. Metabolic syndrome can include type 2 diabetes, high blood pressure, cardiovascular disease, non-alcoholic fatty liver disease, obesity and the phenomenon "TOFI" ("thin-outside-fat-inside").
He argues that fructose can be consumed safely within whole fruits and vegetables because of the role played by the accompanying dietary fiber. But he maintains that the liver is damaged by the fructose in table sugar andhigh-fructose corn syrup that are added to food and beverages (particularly convenience food and soft drinks), and by the fructose in fruit juice and vegetable juice. His position is that sugars are not simply empty calories; he rejects the idea that "a calorie is a calorie."
Lustig was a co-author in 2009 of the American Heart Association's guideline on sugar intake, which recommended that women consume no more than 100 calories daily from added sugars and men no more than 150.That year, a 90-minute lecture by Lustig, "Sugar: The Bitter Truth," recorded in May 2009 for University of California Television,went viral on YouTube. By February 2017, the video had been viewed almost seven million times. The Financial Times called it "sugar's 'tobacco' moment.
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