Sugar and corn syrup have become a large part of the American diet. On average, teenagers get 17 percent of their daily calories from added sugar. Meanwhile, public health officials have taken note that more and more studies suggest a link between sugar consumption and health issues like obesity and diabetes. Some go so far as to say that sugar is toxic to our bodies, and as dangerous to our health as cigarettes. In this series of lesson ideas, which can be done individually or together as part of a larger unit, we'll help students investigate the science and myths about added sugars. How unhealthy are they? What happens to sugar when ingested? How much sugar do we actually consume? Is there a real difference between sugar and corn syrup? And what has the public health response been, and how could it be better? Our final idea brings the unit together as students create their own public health campaigns. Teaching Questions and Activities How unhealthy is sugar? The New York Times Magazine published a cover story investigating whether sugar, in all its forms, was not just a guilty pleasure - but was indeed "toxic" to human health. This story ran over a year before Mayor Bloomberg announced his intention in May 2012 to ban large sugary drinks in New York City. Sugar, corn syrup and processed sweeteners have been blamed for all sorts of health issues, from tooth decay to obesity. But how bad is sugar really? What does the science say? Suggested Activity: In pairs, groups or individually, review and discuss the evidence in various scientific studies reported in The Times: What kinds of claims can be made about the link between sugar and diabetes, obesity, heart disease, weight gain and tooth decay? What claims have the most evidence? Based on the evidence, and that fact that some of the evidence is inconclusive, what health recommendations would you make about sugar consumption? What happens to sugar when it enters the body? Sugar is sometimes called "empty calories" because its consumption provides energy but no nutritional value. Do sugar and corn syrup deserve this description? What is the chemical makeup of sugar, and what happens to sugar as the body digests it? The term "sugar" refers to a broad group of chemical compounds that usually give foods a sweet taste. While numerous public health campaigns promote limiting the amount of sugar in our diets, the body does use sugar to produce chemical energy in the form of ATP. Note: you might need to review, or wish to emphasize, cellular respiration and glycolysis to help students make the connection between the foods they consume and how the body uses them for energy. Milk, fruit, vegetables and other foods contain naturally occurring sugars, like fructose and lactose. Fruits, vegetables and dairy products also provide vitamins, protein and other essential nutrients in addition to the sugars they contain. In comparison, many processed foods contain added sugars, and it is added sugars that many health experts recommend we limit in our diet. These calories are called "empty" because the sugars added to these foods do not include other essential nutrients. A sweet potato, for example, contains natural sugars but it also contains beta-carotene, vitamin A, fiber and other components of a health diet. A can of soda, on the other hand, contains added sugars and none of the nutritional benefits of a fruit or vegetable. Suggested Activity: Students can learn more about what sugar does to the brain and body and then keep a food diary for a week to observe their own intake of sugar and how it affects them. At the end of the week have them analyze exactly what and how many sugars they consumed, and in what form. Are they above or below the norm according to this recent study for their age group and gender? How does their weekly diet compare with that of others in their class? What effects, if any, did they observe in their own bodies before and after they ate sugar? How much sugar and sweetener do Americans consume? What's the big deal anyway? Do we really consume all that much sugar? To find out how much sugar Americans consume, students can read about the government's attempts to estimate our sugar intake. And, they can read about a study focusing on children specifically. Students can also view Times graphics on daily, yearly and lifetime consumption of sugar and corn syrup, images that include wheelbarrows and Jacuzzi pools to get the point across. Suggested Activity: Ask students to guess how much sugar is in a 20 oz bottle of soda, the kind popular in many vending machines and corner stores. Then, you can either use the New York City Health Department video (above) to demonstrate the answer, or actually pour sugar packets into a measure cup for effect. New York State also has a math activity that uses the nutrition labels on a Coca-Cola bottle and Domino sugar packets to solve the problem as well. You can repeat the activity using other soda sizes, like a two-liter bottle, or other foods as well. Ask students: Based on the readings and health department warnings, how much daily sugar intake seems healthy for someone their age? Is there any real difference between sugar and corn syrup? Corn syrup was hailed as an alternative to sugar when it first became popular following the adoption of the 1977 sugar tariffs and quotas, which raised the cost of imported sugar. But lately, corn syrup has been much maligned in the minds of many Americans as being much more unhealthy than "natural" sugar. In fact, by 2010 "over half of all Americans... say they are concerned that high-fructose corn syrup may pose a health hazard, up from 40 percent in 2004." But is corn syrup really any worse than sugar? The corn syrup manufacturers were so spooked by all the negative publicity that they released a commercial fighting back, saying that their product is "made from corn, is natural, and like sugar, is fine in moderation." The commercial inspired plenty of parodies, including this Saturday Night Live one and this spoof comparing corn syrup to cigarettes. Please preview both to make sure they are appropriate for your students. The situation has gotten so gloomy for corn refiners that the industry lobbied to change the name of high fructose corn syrup to "corn sugar." The Times asked a panel of experts to recommend their own new names as well. You can even weigh in on which name you think is best. But, ultimately the F.D.A. denied the petition, and corn syrup will just have to keep its name. But is it all just much ado about nothing? In "Is Sugar Toxic?," Gary Taubes writes all of this condemnation of high fructose corn syrup "borders on humorous": High-fructose corn syrup was portrayed by the food industry as a healthful alternative [in the 1980s], and that's how the public perceived it. It was also cheaper than sugar, which didn't hurt its commercial prospects. Now the tide is rolling the other way, and refined sugar is making a commercial comeback as the supposedly healthful alternative to this noxious corn-syrup stuff.... But marketing aside, the two sweeteners are effectively identical in their biological effects. "High-fructose corn syrup, sugar - no difference," is how Lustig put it in a lecture that I attended in San Francisco last December. The point is they're each bad - equally bad, equally poisonous. Mr. Taubes goes on to describe how sugar and corn syrup behave when ingested: Refined sugar (that is, sucrose) is made up of a molecule of the carbohydrate glucose, bonded to a molecule of the carbohydrate fructose - a 50-50 mixture of the two. The fructose, which is almost twice as sweet as glucose, is what distinguishes sugar from other carbohydrate-rich foods like bread or potatoes that break down upon digestion to glucose alone. The more fructose in a substance, the sweeter it will be. High-fructose corn syrup, as it is most commonly consumed, is 55 percent fructose, and the remaining 45 percent is nearly all glucose. It was first marketed in the late 1970s and was created to be indistinguishable from refined sugar when used in soft drinks. Because each of these sugars ends up as glucose and fructose in our guts, our bodies react the same way to both, and the physiological effects are identical. In a 2010 review of the relevant science, Luc Tappy, a researcher at the University of Lausanne in Switzerland who is considered by biochemists who study fructose to be the world's foremost authority on the subject, said there was "not the single hint" that H.F.C.S. was more deleterious than other sources of sugar. Suggested Activity: Since corn syrup is having a bit of an identity crisis, make a Facebook page for this vilified sweetener. In your page, capture some of the rhetoric on both sides of the battle about the real nature of this nearly ubiquitous ingredient. Here is a template students can use. Below are some questions students can consider in making their page: Who are corn syrup's "friends"? What kinds of posts would corn syrup make? What are some of the photographs it would include in its albums? Where would corn syrup be "tagged"? What kinds of posts would corn syrup's "friends" write? Through your project, make sure you somehow communicate your own ideas about the sugar vs. corn syrup war. What does the science say about corn syrup? Should consumers care about what type of added sugar is in their food? Should marketers care about corn syrup's public image? What actions have public health officials either taken or considered in order to decrease the amount of sugar Americans consume? This week, New York City Mayor Michael Bloomberg's ban on large sugary drinks was struck down by a New York State judge, who ruled that the ban was "arbitrary and capricious." The mayor vowed to appeal the ruling. But whatever the final verdict is for the city's sugary drink limits, New York City's initial foray into government regulation of sugar consumption is likely to continue in one form or another. Suggested Activity: Study the details of the New York City ban and watch the Op-Doc video above, and then make your own judgment. Do you think the government should limit the size of sugary drinks? Do you think the proposal is supported by science? Do you think the proposal, if enacted, would change people's behavior? Do you agree with the judge's decision? After, consider what other proposals are public health officials considering in New York and around the country: Ask students: Which proposals seem to be the most effective or have the most potential? What is your evidence? If you were a public health official in your community, what proposals would you work toward adopting? Then, look at how the soda and sweetener industry has responded to its adversaries: How have industries responded to health initiatives and negative publicity? What do you think about their response? What industry approach do you think is most effective in keeping sales high? What Can You Do? As a culminating activity after students have done one or more of the activities above, invite them to make their own public service announcements, videos, or social media campaigns warning the public of the dangers of added sugar. Who is their targeted audience? How will they get that audience's attention? Students might also write press releases to accompany their campaigns and provide additional science and public health information about sugar-related health problems, consumption habits, and nutritional values. Standard 6. Understands essential concepts about nutrition and diet Standard 8. Knows essential concepts about the prevention and control of disease.