Regulating products based on a scientific risk analysis is a worthy goal, but I contend that Robert Lustig and colleagues oversimplify the “toxic” truth about refined carbohydrates (Nature 482, 27–29; 2012). Rather than demonizing sugar, the authors would have better served public health with recommendations to manage a balanced diet with exercise.

The authors also downplay other complex factors that could contribute to non-communicable disease burdens. These include relatively recent changes in exercise patterns, and pollutants and additives that affect metabolic activity.

Putting sugars in a regulatory league with alcohol and tobacco is misleading. Sugars do not cause behavioural intoxication, nor do they have the second-hand proximity impact of tobacco smoking — key factors in their regulation.