Case 5:16-cv-04955-LHK Document 1 Filed 08/29/16 Page 1 of 148
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`THE LAW OFFICE OF JACK FITZGERALD, PC
`JACK FITZGERALD (SBN 257370)
`jack@jackfitzgeraldlaw.com
`TREVOR M. FLYNN (SBN 253362)
`trevor@jackfitzgeraldlaw.com
`MELANIE PERSINGER (SBN 275423)
`melanie@jackfitzgeraldlaw.com
`Hillcrest Professional Building
`3636 Fourth Avenue, Suite 202
`San Diego, California 92103
`Phone: (619) 692-3840
`Fax: (619) 362-9555
`Counsel for Plaintiff and the Putative Class
`
`
`UNITED STATES DISTRICT COURT
`NORTHERN DISTRICT OF CALIFORNIA
`
`Plaintiff,
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`v.
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`Defendant.
`
`
`STEPHEN HADLEY, on behalf of himself,
`all others similarly situated, and the general
`public,
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`
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`KELLOGG SALES COMPANY,
`
`
`
`Case No.:
`
`CLASS ACTION
`
`COMPLAINT FOR VIOLATIONS OF
`CALIFORNIA’S FALSE ADVERITSING
`LAW, CONSUMERS LEGAL
`REMEDIES ACT, AND UNFAIR
`COMPETITION LAW
`
`DEMAND FOR JURY TRIAL
`
`
`Hadley v. Kellogg Sales Company
`CLASS ACTION COMPLAINT
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`TABLE OF CONTENTS
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`INTRODUCTION .................................................................................................................... 1
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`THE PARTIES ......................................................................................................................... 1
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`JURISDICTION AND VENUE .............................................................................................. 1
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`INTRADISTRICT ASSIGNMENT ......................................................................................... 2
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`FACTS ..................................................................................................................................... 2
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`A.
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`B.
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`C.
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`D.
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`There Has Been a Recent Rise in Human Sugar Consumption .......................... 2
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`The Body’s Physiological Response to Excess Sugar Consumption .................. 6
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`1.
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`2.
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`3.
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`The Body’s Response to Glucose ............................................................. 6
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`The Body’s Response to Fructose ............................................................. 9
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`The Addiction Response ......................................................................... 11
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`There Has Been a Dramatic Rise in Obesity & Chronic Disease That
`Parallels the Rise in Human Sugar Consumption ............................................. 11
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`There is Substantial Scientific Evidence That Excess Sugar
`Consumption Causes Metabolic Syndrome, Cardiovascular Disease,
`Type 2 Diabetes, and Other Morbidity .............................................................. 12
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`1.
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`2.
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`3.
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`4.
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`5.
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`Excess Sugar Consumption Causes Metabolic Syndrome ..................... 13
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`Excess Sugar Consumption Causes Type 2 Diabetes ............................. 16
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`Excess Sugar Consumption Causes Cardiovascular Disease ................. 20
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`Excess Sugar Consumption Causes Liver Disease ................................. 22
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`Excess Sugar Consumption Causes Obesity ........................................... 23
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`6.
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`7.
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`8.
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`9.
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`Excess Sugar Consumption Causes Inflammation ................................. 27
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`Excess Sugar Consumption Causes High Blood Triglycerides
`and Abnormal Cholesterol Levels ........................................................... 29
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`Excess Sugar Consumption is Associated with Hypertension................ 32
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`Excess Sugar Consumption is Associated with Alzheimer’s
`Disease, Dementia, and Cognitive Decline ............................................. 35
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`10. Excess Sugar Consumption is Linked to Some Cancers ........................ 36
`
`E.
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`There is Substantial Evidence That Consuming Artificial Trans Fat—
`Found in Some Kellogg’s Nutri-Grain Bars—is Detrimental to Health ........... 36
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`KELLOGG’S MARKETING & SALE OF HIGH-SUGAR CEREALS & BARS .............. 39
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`A. Kellogg’s Raisin Bran Cereals .......................................................................... 44
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`B.
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`C.
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`1.
`2.
`3.
`4.
`5.
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`Raisin Bran .............................................................................................. 44
`Raisin Bran Crunch ................................................................................. 46
`Raisin Bran Cinnamon Almond .............................................................. 48
`Raisin Bran Omega-3 250mg ALA From Flaxseed ................................ 50
`Raisin Bran with Cranberries ................................................................. 51
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`Kellogg’s Krave Cereals .................................................................................... 53
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`Kellogg’s Frosted Mini-Wheats Cereals ........................................................... 54
`
`Original ................................................................................................... 55
`1.
`2. Maple Brown Sugar ................................................................................ 56
`Strawberry ............................................................................................... 58
`3.
`Blueberry ................................................................................................. 59
`4.
`Big Bite – Original .................................................................................. 60
`5.
`Bite Size – Original, Blueberry Muffin, Strawberry Delight, and
`6.
`Cinnamon Streusel .................................................................................. 61
`Little Bites – Original .............................................................................. 62
`Little Bites – Chocolate ........................................................................... 63
`Little Bites - Cinnamon Roll .................................................................... 64
`Touch of Fruit in the Middle – Mixed Berry ........................................... 65
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`Touch of Fruit in the Middle – Raspberry .............................................. 66
`11.
`Touch of Fruit in the Middle – Raisin ..................................................... 68
`12.
`13. Harvest Delights – Blueberry with Vanilla Drizzle and
`Cranberry with Yogurt Drizzle ............................................................... 69
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`D. Kellogg’s Smart Start – Original Antioxidant Cereal ....................................... 71
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`E.
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`F.
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`Kellogg’s Crunchy Nut Cereal .......................................................................... 73
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`Nutri-Grain Cereal Bars .................................................................................... 74
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`Apple Cinnamon ...................................................................................... 74
`1.
`Blueberry ................................................................................................. 75
`2.
`Strawberry ............................................................................................... 75
`3.
`Cherry ...................................................................................................... 76
`4.
`5. Mixed Berry ............................................................................................. 77
`Strawberry Greek Yogurt ........................................................................ 78
`6.
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`G. Nutri-Grain Soft-Baked Breakfast Bars ............................................................ 78
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`Apple Cinnamon ...................................................................................... 78
`1.
`Blueberry ................................................................................................. 79
`2.
`Strawberry ............................................................................................... 80
`3.
`Cherry ...................................................................................................... 80
`4.
`Raspberry ................................................................................................ 81
`5.
`6. Mixed Berry ............................................................................................. 82
`Strawberry Greek Yogurt ........................................................................ 82
`7.
`Variety Pack ............................................................................................ 83
`8.
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`H. Nutri-Grain Oat & Harvest Bars ....................................................................... 84
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`1.
`2.
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`Blueberry Bliss ........................................................................................ 84
`Country Strawberry ................................................................................. 85
`
`I.
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`Nutri-Grain Harvest Hearty Breakfast Bars ...................................................... 86
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`1.
`2.
`3.
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`Blueberry Bliss ........................................................................................ 86
`Country Strawberry ................................................................................. 86
`Apple Cinnamon ...................................................................................... 87
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`J.
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`Nutri-Grain Fruit Crunch Granola Bars – Apple Cobbler &
`Strawberry Parfait ............................................................................................. 88
`
`K. Nutri-Grain Fruit Crunch Crunchy Breakfast Bars – Apple Cobbler &
`Strawberry Parfait ............................................................................................. 89
`
`L.
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`Nutri-Grain Fruit & Nut Chewy Breakfast Bars – Blueberry Almond
`& Cherry Almond .............................................................................................. 89
`
`KELLOGG’S UNLAWFUL ACTS & PRACTICES ............................................................ 90
`
`A. Kellogg Marketed and Continues to Market Its Cereals and Bars with
`Health and Wellness Claims that are Deceptive in Light of the
`Products’ High Sugar Content ........................................................................... 90
`
`1.
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`2.
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`3.
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`Kellogg Affirmatively Misrepresents that Some High-Sugar
`Cereals are “Healthy,” “Nutritious,” or “Wholesome” ........................... 90
`
`Kellogg Affirmatively Misrepresents that Consuming Some of
`its High-Sugar Cereals and Bars Will Promote Bodily Health,
`Prevention of Disease, or Weight Loss ................................................... 98
`
`Even When Not Stating So Expressly, Kellogg Deceptively
`Suggests Its High-Sugar Cereals and Bars are Healthy ........................ 102
`
`a.
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`b.
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`c.
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`d.
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`Kellogg Touts Its Products’ Whole Grain, Fiber, and
`“Real Fruit” Content to Distract From Their High Sugar
`Content ........................................................................................ 102
`
`Kellogg Deceptively Makes Health and Wellness Claims
`Based on the Use of Milk with its Cereals ................................. 103
`
`Kellogg Leverages a Deceptive Industry “Certification”
`Program—the Whole Grains Council Stamp—to Make
`its High-Sugar Cereals and Bars Seem Healthy ......................... 105
`
`In Representing that Many of Its High-Sugar Bars
`Contain “No High Fructose Corn Syrup,” Kellogg
`Leverages Consumer Confusion to Obscure the Dangers
`of the Bars’ Added Sugars .......................................................... 106
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`e.
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`f.
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`Kellogg Deceptively Markets Some of its High-Sugar
`Cereals as “Simple,” Less Processed Foods ............................... 107
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`Kellogg Deceptively Omits, Intentionally Distracts From,
`and Otherwise Downplays the Cereals’ High Added
`Sugar Content ............................................................................. 107
`
`Kellogg Immorally Marketed Raisin Bran Cinnamon Almond to
`Parents for their Children’s Consumption, Despite that Children
`are the Most Vulnerable to the Dangers of Excess Sugar
`Consumption ......................................................................................... 108
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`Kellogg Egregiously Markets Some High-Sugar Bars with
`Health and Wellness Claims Even Though They Contain
`Artificial Trans Fat ................................................................................ 109
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`4.
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`5.
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`B.
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`C.
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`D.
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`E.
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`6.
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`Kellogg Violates FDA and State Food Labeling Regulations .............. 109
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`Kellogg Knows or Reasonably Should Know of the Strong Scientific
`Evidence Demonstrating Its High-Sugar Cereals are Unhealthy to
`Consume, But Fails to Warn Consumers of the Known Dangers ................... 113
`
`Kellogg Used its Website, as Referenced on Some Labels, and Other
`Online Fora, to Spread Misinformation About the Dangers of
`Consuming the Added Sugar in its Products ................................................... 115
`
`The Foregoing Behaviors are Part of Kellogg’s Longstanding General
`Policy, Practice and Strategy of Marketing its High-Sugar Cereals and
`Bars as Healthy in Order to Increase Sales and Profit .................................... 127
`
`Kellogg’s Policy and Practice of Marketing High-Sugar Cereals as
`Healthy is Especially Harmful Because Consumers Generally Eat
`More than One Serving of Cereal at a Time, Which Kellogg Knows or
`Reasonably Should Know ............................................................................... 128
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`PLAINTIFF’S RELIANCE & INJURY .............................................................................. 129
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`CLASS ACTION ALLEGATIONS .................................................................................... 135
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`CAUSES OF ACTION ........................................................................................................ 138
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`PRAYER FOR RELIEF ....................................................................................................... 140
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`JURY DEMAND ................................................................................................................. 141
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`Plaintiff Stephen Hadley, on behalf of himself, all others similarly situated, and the
`general public, by and through his undersigned counsel, hereby brings this action against
`Kellogg Sale Company (“Kellogg”), and alleges the following upon his own knowledge, or
`where he lacks personal knowledge, upon information and belief including the investigation
`of his counsel.
`
`INTRODUCTION
`The scientific evidence is compelling: Excessive consumption of added sugar
`1.
`is toxic to the human body. Experimentally sound, peer-reviewed studies and meta-analyses
`convincingly show that consuming excessive added sugar—any amount above approximately
`5% of daily caloric intake—greatly increases the risk of heart disease, diabetes, liver disease,
`and a wide variety of other chronic morbidity.
`Despite the compelling evidence that sugar acts as a chronic liver toxin,
`2.
`detrimentally affecting health, to increase the price and sales of its products, Kellogg
`leverages a policy and practice of marketing high-sugar cereals and bars with health and
`wellness claims. These claims, however, are deceptive because they are incompatible with
`the dangers of the excessive sugar consumption to which these foods contribute.
`Plaintiff brings this action against Kellogg on behalf of himself, other
`3.
`consumers, and the general public, primarily to enjoin Kellogg from using deceptive health
`and wellness claims to market high-sugar foods.
`THE PARTIES
`Plaintiff Stephen Hadley is a resident of Monterey, California.
`4.
`Defendant Kellogg Sales Company is a Delaware corporation with its principal
`5.
`place of business at One Kellogg Square, Battle Creek, Michigan 49016.
`JURISDICTION AND VENUE
`This Court has jurisdiction over this action pursuant to 28 U.S.C. §
`6.
`1332(d)(2)(A), the Class Action Fairness Act, because the matter in controversy exceeds the
`sum or value of $5,000,000 exclusive of interest and costs, at least one member of the class
`of plaintiffs is a citizen of a State different from Kellogg. In addition, more than two-thirds
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`of the members of the class reside in states other than the state in which Kellogg is a citizen
`and in which this case is filed, and therefore any exceptions to jurisdiction under 28 U.S.C. §
`1332(d) do not apply.
`The Court has personal jurisdiction over Kellogg pursuant to Cal. Code Civ. P.
`7.
`§ 410.10, as a result of Kellogg’s substantial, continuous and systematic contacts with the
`State, and because Kellogg has purposely availed itself of the benefits and privileges of
`conducting business activities within the State.
`Venue is proper in this Northern District of California pursuant to 28 U.S.C. §
`8.
`1391(b) and (c), because Kellogg resides (i.e., is subject to personal jurisdiction) in this
`district, and a substantial part of the events or omissions giving rise to the claims occurred in
`this district.
`
`INTRADISTRICT ASSIGNMENT
`Pursuant to N.D. Cal. Civ. L.R. 3-2(c), (d) & 3-5(b), this action is properly
`9.
`assigned to the San Jose Division because the action arises in Monterey County in that a
`substantial part of the events or omissions that give rise to plaintiffs’ claims occurred in
`Monterey County.
`
`FACTS
`A. There Has Been a Recent Rise in Human Sugar Consumption
`10. Sugars are sweet, short-chain, soluble carbohydrates. Simple sugars are called
`monosaccharides, while disaccharides are formed when two monosaccharides undergo a
`condensation reaction. The three most common sugars in our diets are fructose, glucose, and
`sucrose. Other sugars, like lactose, found in milk, and maltose, formed during the germination
`of grains like barley, are not generally consumed in large amounts. Glucose is a
`monosaccharide that occurs naturally in fruits and plant juices and is the primary product of
`photosynthesis. Most ingested carbohydrates (like bread and pasta) are converted into glucose
`during digestion, and glucose is the form of sugar transported around the body in the
`bloodstream, and used by the cells for energy. Fructose is a monosaccharide that occurs
`naturally in fruits and honey. It is the sweetest of the sugars. Sucrose is a disaccharide
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`comprised of one molecule of glucose chemically linked to one molecule of fructose. It is
`found in sugar cane and beets. Common table sugar is sucrose. During digestion and prior to
`blood absorption, enzymes called sucrases cleave a sucrose molecule into its constituent parts,
`glucose and fructose.
`11. Humans’ consumption of sugar has shifted dramatically over time. Cro-Magnon
`men during the Paleolithic age were hunters and gatherers, with a diet mainly comprised of
`meat, high in protein, moderate in fat, and low in carbohydrates. Fruits and berries were the
`major source of carbohydrates, and starch consumption was low.1 In 1200 B.C., a process
`was developed in India for extracting sugar in the form of cane juice called khanda, which is
`where the word “candy” comes from. For nearly 3,000 years, sugar was rare, reserved for
`nobility. The invention of the pot still in 1700 A.D., however, allowed mass production of
`refined sugar. But it was still extraordinarily expensive until the middle of the 18th century,
`when there was a worldwide growth in sugar production, including in America. Thus, humans
`have been consuming sugar in substantial amounts for less than 300 years.
`12. For most of that time, Americans’ sugar consumption was almost exclusively
`table sugar, with only small amounts of glucose and fructose ingested from fruit.2 And sugar
`was a condiment, added to coffee or tea, with control over the amount eaten.
`In the 1960s, the food industry developed technologies to extract starch from
`13.
`corn, then convert it to glucose, some of which could then be converted to fructose, leading
`to the development of corn-derived sweeteners, most notably high-fructose corn syrup
`(HFCS).3 Although HFCS is comprised of both fructose and glucose, unlike with sucrose, the
`fructose is not chemically bound to the glucose in a new molecule. Thus the fructose in HFCS
`
`
`1 Tappy, L., et al., “Metabolic Effects of Fructose in the Worldwide Increase in Obesity,”
`Physiology Review, Vol. 90, 23-46, at 24 (2010) [hereinafter “Tappy, Metabolic Effects of
`Fructose”].
`
`2 Id.
`
`3 Id. (citation omitted).
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`is referred to as “free” fructose. HFCS can be produced with different fructose-to-glucose
`ratios. The most common are HFCS-42 and HFCS-55, containing 42% and 55% fructose.
`Some HFCS, however, can be as much as 90% fructose, i.e., HFCS-90. Food manufacturers
`have recently begun referring to HFCS-90 on food label ingredients statements as simply
`“fructose.”
`14. Fructose is sweeter than either glucose or sucrose. In fruit, it serves as a marker
`for foods that are nutritionally rich. Before the development of the worldwide sugar industry,
`fructose in the human diet was limited to items like honey, dates, raisins, molasses, figs,
`grapes, raw apples, apple juice, persimmons, and blueberries (which contain approximately
`10-15% fructose). Food staples like milk, vegetables, and meat have essentially no fructose.
`Thus, until relatively recently, human beings have had little dietary exposure to fructose.4
`15. But the low cost and long shelf-life of HFCS has contributed to a rapid increase
`in its consumption over the last 45 years, and thus the consumption of fructose. Between 1970
`and 2000, the United States’ yearly per capita HFCS consumption went from 0.292 kg per
`person, to 33.4 kg per person, a greater than 100-fold increase.5
`16. Today, the majority of sugars in typical American diets are added to foods during
`processing, preparation, or at the table.6 The two primary sources of added sugar in processed
`food are HFCS and sucrose (i.e., granulated sugar used, for example, in baked goods). Added
`
`
`4 Bray, G., “How bad is fructose?,” American Journal of Clinical Nutrition, Vol. 86, 895-96
`(2007) [hereinafter, “Bray, How Bad is Fructose?”].
`
`5 Bray, G.A., et al., “Consumption of high-fructose corn syrup in beverages may play a role
`in the epidemic of obesity,” American Journal of Clinical Nutrition, Vol. 79, 537-43, at 537,
`540 (2004) [hereinafter “Bray, HFCS Role in Obesity Epidemic”].
`
`6 U.S. Dep’t of Agric. & U.S. Dep’t of Health & Human Servs., “Dietary Guidelines for
`available
`at
`Americans,
`2010,”
`at
`27
`(2010)
`http://www.health.gov/dietaryguidelines/dga2010/DietaryGuidelines2010.pdf.
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`sugar is in more than 74% of processed foods,7 under more than 60 different names.8
`Although the tendency is to associate sugar with sweets, added sugar is found in many savory
`processed foods, like bread, soup, and pasta sauce.
`17. There has been a rise over the past 45 years in Americans’ consumption of added
`sugars. From 1970 to 2000, there was a 25% increase in available added sugars in the U.S.9
`The American Heart Association found that between 1970 and 2005, sugars available for
`consumption increased by an average of 76 calories per day, from 25 teaspoons (400 calories)
`to 29.8 teaspoons (476 calories), a 19% increase.10 The Continuing Survey of Food Intake by
`
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`7 Ng, S.W., et al., “Use of caloric and non-caloric sweeteners in US consumer packaged foods,
`2005-9, Journal of the Academy of Nutrition and Dietetics, Vol. 112, No. 11, 1828-34 (2012).
`
`8 Some examples: Agave nectar, Barbados sugar, Barley malt, Barley malt syrup, Beet sugar,
`Brown sugar, Buttered syrup, Cane juice, Cane juice crystals, Cane sugar, Caramel, Carob
`syrup, Castor sugar, coconut palm sugar, Coconut sugar, Confectioner’s sugar, Corn
`sweetener, Corn syrup, Corn syrup solids, Date sugar, Dehydrated case juice, Demerara
`sugar, Dextrin, Dextrose, Evaporated cane juice, Free-flowing brown sugars, Fructose, Fruit
`juice, Fruit juice concentrate, Glucose, Glucose solids, Golden sugar, Golden syrup, Grape
`sugar, High-Fructose Corn Syrup (HFCS), Honey, Icing sugar, Invert sugar, Malt syrup,
`Maltodextrin, Maltol, Maltose, Mannose, Maple syrup, Molasses, Muscovado, Palm sugar,
`Panocha, Powdered sugar, Raw sugar, Refiner’s syrup, Rice syrup, Saccharose, Sorghum
`Syrup, Sucrose, Sugar (granulated), Sweet Sorghum, Syrup, Treacle, Turbinado sugar, and
`Yellow sugar.
`
`9 Bray, How Bad is Fructose?, supra n.4, at 895 (citing Havel, P.J., “Dietary fructose:
`implications for dysregulation of energy homeostasis and lipid/carbohydrate metabolism,
`Nutrition Reviews, Vol. 63, 133-57 (2005) [hereinafter, “Havel, Dietary Fructose”]).
`
`10 Johnson, R.K., et al., on behalf of the American Heart Association Nutrition Committee of
`the Council on Nutrition, Physical Activity, and Metabolism and Council on Epidemiology
`and Prevention, “Dietary Sugars Intake and Cardiovascular Health: A Scientific Statement
`From the American Heart Association,” Circulation, Vol. 120, 1011-20, at 1016-17 (2009)
`[hereinafter “AHA Scientific Statement”]. See also World Health Organization, Sugars intake
`available
`at
`for
`adult
`and
`children: Guideline”
`(March
`4,
`2014)
`http://www.who.int/nutrition/publications/guidelines/sugars_intake/en (Based on scientific
`evidence, recommending adults and children reduce daily intake of free sugars to less than
`10% of total energy intake and noting that “[a] further reduction to below 5% or roughly 25
`grams (6 teaspoons) per say would provide additional health benefits.”).
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`Individuals from 1994 to 1996 showed that the average person had a daily added sugars intake
`of 79 grams, equal to 316 calories and about 15% of energy intake. Those in the top one-third
`of fructose consumption ingested 137 grams of added sugars per day (548 calories, about
`26% of energy per day), and those in the top 10% of fructose consumption ingested 178 grams
`of fructose per day (712 calories, about 34% of energy).11
`In 2014, researchers analyzing data obtained from National Health and Nutrition
`18.
`Examination Survey (NHANES) showed that during the most recent period of 2005-2010,
`the mean percent of calories from added sugar in the American diet was 14.9%. Most adults,
`71.4%, consumed 10% or more of their calories from added sugar, while about 10% of adults
`consumed 25% or more of their calories from added sugar.12
`19. Today, “the vast majority of the U.S. population exceeds recommended intakes
`of . . . added sugars.”13 Despite some reduction in added sugar intake recently, “intakes of
`added sugars are still very high . . . and are well above recommended limits . . . .”14
`Approximately 90% of the population exceeds recommended daily limits.15
`The Body’s Physiological Response to Excess Sugar Consumption
`B.
`The Body’s Response to Glucose
`1.
`20. The body needs some glucose, largely to meet the brain’s metabolic demands,
`
`
`11 Bray, How Bad is Fructose?, supra n.4, at 895.
`
`12 Yang, Quanhe, et al., “Added Sugar Intake and Cardiovascular Diseases Mortality Among
`US Adults,” Journal of the American Medical Association, at E4-5 (published online Feb. 3,
`2014) [hereinafter, “Yang, NHANES Analysis”].
`
`13 U.S. Dep’t of Agric. & U.S. Dep’t of Health & Human Servs., “Scientific Report of the
`2015 Dietary Guidelines Advisory Committee: Advisory Report to the Secretary of Health
`and Human Services and the Secretary of Agriculture,” at 26 (February 2015), available at
`http://www.health.gov/dietaryguidelines/2015-scientific-report/PDFs/Scientific-Report-of-
`the-2015-Dietary-Guidelines-Advisory-Committee.pdf.
`
`14 Id. at 38.
`
`15 Id. at 35.
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`6
`Hadley v. Kellogg Sales Company
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`but also because all living cells use glucose for energy. Blood glucose levels below 25mg/dL
`may result in coma, seizure, or death, while levels consistently exceeding 180 mg/dL can
`cause long-term damage, including renal failure and atherosclerosis.
`21. For these reasons, blood glucose concentration is tightly-regulated by
`homeostatic regulatory systems. When blood glucose rises after a meal, beta cells in the
`pancreas secrete insulin into the blood, which helps muscle, fat, and liver cells absorb the
`glucose for energy, lowering the blood sugar. Too little blood sugar stimulates the secretion
`of hormones that counteract the insulin and thus restore normal blood sugar.16
`22. During certain steps in processing glucose, the body forms fructose. However,
`unlike with glucose, there is no biological need for dietary fructose, i.e., fructose consumed
`from food, whether fruit, honey, HFCS, or some other form. Moreover, unlike glucose,
`fructose does not directly stimulate insulin secretion.
`23. The body processes glucose and fructose differently. With little processing,
`fructose passes through the small intestine, into blood bound for the liver, so that it is taken
`up nearly 100% for processing in the liver (a characteristic shared by substances commonly
`referred to as poisons). By contrast, glucose is both “burned up” by cells directly, and
`processed elsewhere outside the liver, so that the liver must process only 20% of glucose
`consumed.
`24. So much glucose is burned up prior to liver processing, because all the body’s
`cells contain a transporter that, when stimulated by insulin, takes in glucose from the blood.
`By contrast, fructose can only be absorbed by cells that contain a different transporter, which
`most cells lack.
`25. The liver is capable of processing relatively small amounts of sugar, meted out
`slowly. This is one of the reasons that eating the fructose in fruit is not problematic: the fiber
`slows the sugar’s uptake, and some sugars incased in fiber may not even be released, and thus
`
`16 Ludwig, David S., “The Glycemic Index: Physiological Mechanisms Relati