Guest Essay by Kip Hansen
Prologue: This is the third in a series of several essays that will discuss ongoing scientific controversies, a specific type of which are often referred to in the science press and elsewhere as “Wars” – for instance, this essay covers the War on Sugar. Kahan, in his recent “On the Sources of Ordinary Science Knowledge and Extrarodinary Science Ignorance”, refers to such controversies as “the Science Communication Problem” characterized by their “signature form of persistent contestation”. For the record, I admire Kahan’s analysis, but do not agree with it. The purpose of the series is to illuminate the similarities and differences involved in each of these controversies. I will share my analysis in an essay at the end of the series. Earlier essays in this series are here and here.
Warning: This is not a short essay. Dig in when you have time to read a longer piece.
“Our bodies need one type of sugar, called glucose, to survive. ‘Glucose is the number one food for the brain, and it’s an extremely important source of fuel throughout the body,’ says Dr. Kristina Rother, an NIH pediatrician and expert on sweeteners. But there’s no need to add glucose to your diet, because your body can make the glucose it needs by breaking down food molecules like carbohydrates, proteins, and fats.
“Some sugars are found naturally in foods, such as fruits, vegetables, and milk. ‘These are healthful additions to your diet,’ says Dr. Andrew Bremer, a pediatrician and NIH expert on sweeteners. ‘When you eat an orange, for instance, you’re getting a lot of nutrients and dietary fiber along with the natural sugars.”
“Although sugar itself isn’t bad,’ says Rother, ‘sugar has a bad reputation that’s mostly deserved because we consume too much of it. It’s now in just about every food we eat.” – NIH “Sweet Stuff”
I’ve bolded the central issue in the War on Sugar. The proponents of the War on Sugar – those fighting to eliminate — or at least sharply reduce the amount of – sugar from the American diet have painted sugar as bad – have made sugar into a villain – because it is too popular – people like it and, in the opinion of the anti-sugar advocates, eat too much of it. We should additionally note that sugars are one of the carbohydrates that the body breaks down into glucose – also known as blood sugar. This illogic – sugar is bad because we eat too much of it — is then used to vilify food producers who use sugar in their products – positioned as unnecessary, too much, wrong kind – an endless attack on a substance that is not only innocent, but is a necessary part of the human diet and the main source of quick energy for most higher life forms on earth.
The War on Sugar is dissimilar to the two previous Science Wars discussed so far in this series: The Salt Wars and the Great Barrier Reef Wars. In those previously covered wars, we found two groups of scientists, one on each apparent more-or-less polarized side of the issue, each surrounded by followers in civil society – activist groups, media, and citizens – who are also polarized on the issues involved. In the War on Sugar, we find almost exclusively a large monolithic body of science and health researchers, ‘science popularizers’ and government agencies waging an endless battle against what they see as the inertia of the general public – who for the most part refuse to do as they are told and give up, or at least eat less, sugar — and, as is common in science wars, assert that there is a conspiracy called Big Sugar (which includes all food producers and anyone else not aligned with their view).
The anti-sugar forces use logic like this: “Several studies have found a direct link between excess sugar consumption and obesity and cardiovascular problems worldwide,” Bremer says. Because of these harmful effects, many health organizations recommend that Americans cut back on added sugars.” (NIH – ibid)
All of us who have studied and trained ourselves to read health studies and findings see right away the problem here. The finding of “links” (direct or not) between two or three things is [almost] meaningless. To then make society-wide health or diet recommendations on this sort of weak evidence is not scientific.
As in both of the previous wars, we find that the War on Sugar, has at its core a simple and basic truth, with which most people would agree is true (or, more precisely, true enough). All sugars have high caloric values – they are loaded with calories, packed with chemical energy. [Simplification Warning – the following is actually far more complicated, but this will suffice for now.] In a very general sense, human bodies need to take in as much energy as they expend – they operate on an energy budget. If one expends more energy than one takes in, the body starts using itself as an energy/food source. It begins breaking down its stored fat and uses it for energy. If it runs out of fat stores, it begins to break down the fabric of the body itself – one is starving. On the other hand, if one takes in more energy – more calories – than one expends, then the body stores the extra energy by converting it to fat – its ready pantry of food storage – which can be used later if needed.
The current public health view is that all “excess body fat” is bad, bad, bad – a view that ignores the incontrovertible evidence that so-called overweight people live the longest compared to so-called normal weight and obese people– a fact named The Obesity Paradox.
It is well established that the morbidly obese – those with body mass indexes exceeding 35 or so – are prone to a bevy of health problems which include diabetes and cardiovascular problems associated with high blood pressure. It is not yet entirely clear what type of comorbidity exists between obesity and the related health problems – the choices being: direct causation, associated risk factors, heterogeneity, independence – but the general view is that obesity is either a direct cause or a very high risk factor and thus, if there were less obesity, there would be fewer cases of diabetes and heart disease, a win for individual health, public health and a savings in health care costs.
Thus, the current prominent public health view that eating sugar leads to weight gain which can lead to overweight which can then, if the trend continues, lead to obesity which is a risk factor for diabetes and heart disease – therefore: Eating excess sugar must stop.
The basic truth is that people who are concerned about unwanted weight gain, who are dangerously overweight or who have problems related to the body’s sugar-processing functions, should consider reducing the overall calorie intake – with sugars, particularly added sugars, being the easiest calories to identify and reduce.
If this were The Public Health Message About Sugar all would be well – there would be no controversy and no need of a science war. This true and accurate health message has apparently – see the rising tide of obesity – failed to convince, or failed to help, those to whom it is rightly addressed. The “chain-of-evidence” indicting dietary sugar as the [or even a] cause of diabetes or of high blood pressure or of obesity and related heart disease involves way too many “can lead to”s – the evidence itself is weak.
It is because the evidence is so weak that anti-sugar forces, which include the FDA (plus the usual cadre of health food and health fad advocacy groups), must rely on exaggerated framing of the evidence in order to justify their policy recommendations.
In a nutshell: The claimed basis for the War on Sugar is that sugars – particularly added sugars, a phrase used to avoid indicting fruits, fruit juices, sweet vegetables and milk – are “empty calories” that when ingested in excess can lead to weight gain which can then lead to diabetes, metabolic syndrome and cardiovascular disease.
[ It might be well to point out, as an aside, that when I was in hospital following a heart attack, the nice nurse, on orders from my doctor, plugged a tube into my arm that fed me normal saline solution (salt water) laden with dextrose/glucose (sugar) – those vilified “empty calories” – to sustain my life while I was unable to eat other foods. ]
On the same advice page from the National Institutes of Health, the conclusion is given as:
“In the long run, if you want to lose weight, you need to establish a healthy lifestyle that contains unprocessed foods, moderate calories, and more exercise,” Rother says. [Dr. Kristina Rother, an NIH pediatrician and expert on sweeteners]….
“The key to good health is eating a well-balanced diet with a variety of foods and getting plenty of physical activity. Focus on nutrition-rich whole foods without added sugars.” [emphasis mine – kh]
The majority of this conclusion is scientific and based on good research that returns useful information to nutritionists who have translated it into good clinical advice. The emphasized words and phrases are advocacy and are only very vaguely based on science at all.
There is no evidence, given a well-rounded diet, that “unprocessed” foods are more healthful than processed foods or that well-rounded diets should focus on “whole foods” (a marketing term, not a scientific term) and foods that are free of added sugars.
By the way, the science expressly states, contrary to common belief, that sugar consumption, even excess sugar consumption, does not cause diabetes. (WebMD, supplier of the video making this point, is apparently so sure of the opposite opinion that they named the video file “kahn-eating-sugar-cause-diabetes”.]
Back to Earth: None of these facts should be taken to mean that I, or anyone else, would not suffer health consequences if I ate nothing but ice cream, sugared donuts, honey-sweetened smoothies, drank liter-after-liter of full-sugar soft drinks or chug-a-lugged can-after-can of sugar-laden, over-caffeinated energy drinks alternated with Snickers and Mars bars. That, my kind friends, does not a well-rounded diet make. As with all things, the poison is in the dose, and sugars, as with every other type of food, probably have some natural limit.
[voice-over] AND NOW FOR A LOOK AT THE HEADLINES:
The War on Sugar and How We Can Win It — 05/20/2015 — Jose Aristimuno at HuffPo Blog
“If every candy bar and soda across the country carried a warning label just like a pack of cigarettes does, then our country would start to see our sugar consumption go down, just as we have been able to see it happen within the Tobacco industry.”
Eating too much added sugar increases the risk of dying with heart disease — February 06, 2014 –Julie Corliss, Executive Editor, Harvard Heart Letter
“Nutritionists frown on added sugar for two reasons. One is its well-known links to weight gain and cavities. The other is that sugar delivers “empty calories” — calories unaccompanied by fiber, vitamins, minerals, and other nutrients. Too much added sugar can crowd healthier foods from a person’s diet.”
AND BOOK TITLES:
Sweet Poison: Why Sugar Makes Us Fat by David Gillespie
Suicide by Sugar by Dr. Nancy Appleton
Sugar Nation: The Hidden Truth Behind America’s Deadliest Habit and the Simple Way to Beat It by Jeff O’Connell
The Sugar Addict’s Total Recovery Program by Kathleen DesMaisons
The Real Truth About Sugar: Dr. Robert Lustig’s “Sugar: The Bitter Truth” by Samantha Quinn
Sweet Pete: A story about a bunny who ate too much sugar (a children’s book) by Maria Alony and Heidi Rodis
Sugars and Flours: How They Make us Crazy, Sick and Fat, and What to do About It by Joan Ifland
[ Disclosure: I have read all the articles linked, plus approximately 100 others, as well as dozens of journal articles on the sugar issue, but have only read one of the books: Sweet Pete: A story about a bunny…. ]
“Sugar is poison” (Dr. Lustig and others), “sugar is killing or will kill us”, “sugar is like tobacco”, “sugar makes us crazy”, “sugar is addictive (like cocaine or heroin)”.
These are not the messages of calm, deliberative nutritional science. They are wild and unfounded exaggerations, unlikely extrapolations, symptoms of “public health epidemiology” and the inevitable propagandists’ tool, “sugar is the first step on the slippery slope to morbid obesity, metabolic syndrome, diabetes, and eventual death from heart disease.”
Who, you may rightly ask, is on the side of rationality in this controversy? Very few, and far between.
In this War, we see industry forces whose profits depend in part on high-sugar content foods and drinks funding research in hopes of clarifying the science. Regardless of the findings, the strength of the science, and the thoroughness of the methods, industry science is discredited and discounted.
There are a few voices that occasionally fight back against the exaggerators – write articles pointing out that sugar is not poison, for instance, Ross Pomeroy and David Katz among them. Those who are too outspoken are accused of working for Big Sugar.
The War on Sugar is intertwined with the Obesity Wars, the Soda Wars and HFCS Wars (a sub-set of the War on Sugar).
But we see some common features with the two previously discussed Wars: there is polarization among scientists and the general public, there is resistance to those changes in public policy being insisted on by those speaking for Science, when evidence is weak or only associational, proponents of policy change have exaggerated risks and inflated expected benefits of proposed policy changes to make their messages more powerful (but less true), the general public may pay lip service to the messages (many say they are avoiding sweets) but does not change its behavior (sales of sugar laden StarBigBucks coffee continue to soar, so-called energy drinks – contents: sugars and caffeine — have grabbed a huge bite of the canned drinks market, US candy sales increased from 6.8 billion dollars in 2009 to 8 billion dollars in 2014).
As of 2015, the combined billions of dollars of research expended on the sugar question have allowed us to reach this conclusion:
“Conclusion: There are epidemiological data, plausible mechanisms and clinical data from diet intervention studies that provide strong support for a direct causal/contributory role of sugar in the epidemics of metabolic disease, and for an indirect causal/contributory role mediated by sugar consumption promoting body weight and fat gain. Yet, these are still controversial topics.” Kimber L. Stanhope (2016) Sugar consumption, metabolic disease and obesity: The state of the controversy, Critical Reviews in Clinical Laboratory Sciences, 53:1,52-67 DOI: 10.3109/10408363.2015.1084990
Medical/Nutritional science has made the long, long loop back to where it stood 40 years ago: sugar, representing calories, may cause or contribute to ‘metabolic disease’, meaning 3-out-of-5 of obesity, elevated blood pressure, elevated fasting plasma glucose, high serum triglycerides, and low high-density lipoprotein (HDL) levels. [NB: Metabolic syndrome is associated with the risk of developing cardiovascular disease and diabetes.] and may indirectly cause or contribute to “promoting body weight and fat gain”.
Overeating, over-consumption of calories beyond your energy expenditure may cause you to gain weight and, if you do become too heavy, too fat, it can adversely affect your health. This we already knew.
The policy proposals that the general public must be somehow forced to reduce their intake of sugars, through FDA nutritional advice, pressure on the food industry to reduce added sugars, through outright propaganda aimed at the public, and through attacks-by-regulation (so-called soda taxes) on the sugared-drinks industry are all based on the premise that if the public consumed less sugar they would be less fat and more healthy – yet another “one substance solution” which is almost certain to be only a part of the problem that is as yet only vaguely understood. Policies to enforce the premise as a society-wide solution to obesity or metabolic syndrome or diabetes are most likely to fail because they do not solve the right problem and the general public will not act on such weak evidence of potential harms. The general public recognizes the “advocate that exaggerates” as an untrustworthy source of information and discounts all his advice, rejecting the good along with the bad.
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Author’s Comment Policy:
I have personal experience with added calories – if I drink highly-sugared beverages and eat primarily restaurant food – which I did for months at a time when traveling for business, staying in hotels, in the 1990s – I put on 10-15 pounds of extra weight. I knew it would happen, but one pays the price of doing business. On return home, to home-cooked meals and more choices, I readily dropped the extra weight. The cycle was repeated several times. I am now, as I have habitually been, a perfectly normal-weighted middle-age-shaped man, with a current BMI of 24. I have a sweet tooth and childishly enjoy a bit of candy or a dish of ice cream occasionally. I don’t have any stake in the War On Sugar, with the exception of my concern for the extent of the harm that these modern scientific controversies do to the reputation of science.
I will be glad to answer your questions about the War on Sugar – I have been following it for at least 15 years.
I realize that many readers here will want to move on immediately to discuss the parallel problems in the Climate Wars. I ask that you please try to restrain yourselves – we’ll get to that later on in the series.
I am still open to suggestions on which of the current Science Wars to cover in this series, I am aware of a half dozen or more. I have more-or-less promised to cover the Ozone Wars dealing with the so-called hole in the ozone layer.
The last essay in the series will be an attempt to layout a coherent pattern of modern science wars and maybe suggest ways that the different science fields themselves can break these patterns and return their specific area of science back to the standards and practices that should exist in all scientific endeavors.
Thank you for reading here.
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the time to READ labels is important
if I make a pasta sauce its tomatos,plus paste, no added sugar, meat onion garlic herbs,pinch of salt or a stock cube and maybe a splash of red wine.
if you buy a commercial version sugar isnt far down the list
and the desired item in ANY food producers menu is one known as “cleanlabel”
ie it does NOT have to be included IN the list so can be quite a range of starches fillers etc
sugar and the fillers bulk up and add gloss to food
if you want to see the “gloss” explained
stew some appleswithout sugar their appearance is sort of flat and possibly grainy
with sugar they look a bit less dull -not much sugar;-)
now add some cornflour paste and reheat
its all smooth and shiny and bulked up and sits IN a piecrust etc better
commercial prepared foods can hold more water due to fillers, and sugar syrup added in makes the bland taste due to lack of REAL food in them, less noticeable.
having some pretty old cookbooks and reading recipies made me notice the HUGE changes in ingredients and sizes of portions considered “normal” today.
a cake using 2 level tablespoons of cocoa powder was considered pretty decadent way back then
now its likely to have half a cup cocoa or some choc goop and 4x the sugar ie from 1/4 to max Half a cup to 1.5 to 2 cups syrup /sugar.
Reading the comments, it seems obvious no one has more than a vague idea how nutrition works, but everyone has a theory or a diet or a philosophy that they are sure is correct. So much for science. It’s more like faith-based eating.
In the end you have to do what works for you as an individual.
Anyone who has trained for serious competitions knows some things work for them and some don’t.
These blanket recommendations that everybody should do this or that are just bull.
Further the claim that “scientists” know more about nutrition than the rest of us is misinformed. That is why the food recommendations keep flopping around like a dying fish.
Until an independent group is set up to do hostile review of biomedical studies, with an emphasis on identifying incompetence or misconduct we really don’t know what to believe.
AMGEN tried to reproduce 56 landmark (not fly-by-night) studies and only could reproduce 6. 89% of the “Landmark” studies were wrong. Scientists should not place marks on land because they are incompetent and put them in the wrong spot. Applying this to the nutrition field this means that the vast majority of the recommendations are simply wrong.
It sort of is what it is. Until the government mandates hostile review of all government funded studies most of science is going to be a joke.
As long as you make some attempt to balance your diet and don’t just consume cokes, hot dogs, and ice cream you are probably ok.
“Faith-based eating ” – Excellent comment & true … and this is a result of the Diet & Sugar wars & their related wars – it is very difficult for the average busy person to sort it all out & figure out what to do ( if anything) about healthy eating & correct nutrition , thus leaving a “faith-based eating” as the only viable solution for many – science wars in general lead to faith-based solutions / beliefs as good science isn’t being done or isn’t understood by the masses.
Insulin is an anabolic hormone, it causes growth and weight gain. One of the major class of growth hormones in your body are the insulin like growth factors, IGFs. They test pregnant women for blood glucose levels because of gestational diabetes, where persistently elevated insulin causes higher birth weights and potential complications related to large babies.
There is also a counterintuitive link between sugar or protein and cancer/longevity. If you feed a lab mouse a low calorie diet they live longer. I think this represents a dieting/starvation/survival mode. If you eat an excess of food then insulin and higher nutrition cause growth and cancer is just unrestrained growth.
It is also no coincidence that body builders have to strictly limit high Glycemic index foods when they are trying to cut extra weight before a competition. When they’re trying to put on muscle insulin helps them do that but when they want to slim down it works against them.
It’s about much more than sugar being ’empty calories. Please watch Dr Lustig’s lecture on the subject…
https://youtu.be/dBnniua6-oM
Marcos this is the list of drugs I was taken two years ago: prednisone and norvasc , metformin, lipitor and antibiotics every 4 to 6 weeks. Today none not even an aspirin. Dr. Lustig video was one of the first I followed and Dr Tim Noakes is my hero.
I have bridge for sale…….
Reply to Marcos ==> Dr. Lustig is one of the most polarized of the anti-sugar advocates, and is unfortunately responsible for much of the mis-information involved in the War on Sugar.
Wow, so many opinions and no focus on how the bio-chemistry really works. Just a few factoids. Everything you eat is processed by the liver. A tidal wave of fatty liver driven disease is coming to crash our medical system. If you have 2 friends one of you has a fatty liver. Unheard of 40 years ago. Does that matter? Well, only if you develop liver disease. You may not know that there are no medical treatments for cirrhosis other than transplant. 100 million Americans now have a fatty liver. The problem is recent enough that we don’t have really reliable statistics but some estimate that 5 million current citizens will die of end stage liver disease and within the next couple of years it will be the number one cause of transplants. The problem is entirely diet driven. Excess saturated fat overwhelms the livers ability to manage the flow because triglyceride chemistry is complex. Unmanaged fats deposit in the liver putting it at risk. Anything that causes inflammation results in the death of liver cells and the formation of fibrosis ultimately leading to cirrhosis if continued long enough. So where does sugar fit. The fructose that is 50% of table sugar must be processed by the liver. As a poor diet gradually kills liver cells it becomes harder for the remaining cells to succeed and over time the chemistry breaks down and more cells die. Once you put yourself on the toboggan ride to hell of liver damage sugar is not your friend because it consumes processing capacity without a payload of nutrition. Keep it up and you probably die badly. Chronic obesity and insulin metabolic resistance are usually the first steps into the tunnel of illness that is end stage liver failure and diet is what will take you there. As a lifestyle use poly unsaturated fats and limit dietary sugar. Simplest way to live long and prosper if you exercise regularly.
It’s a long journey from fatty liver to liver cirrhosis. Fatty liver is reversible if you shed weight and adjust your diet. If you don’t, chances are that your fatty liver will stay put, without deteriorating into anything worse.
The liver is well equipped for processing the fructose we give it. For a while around the 1970, fructose was even used as a substitute for glucose in intravenous nutrition. That’s right, patients unable to eat received all their calories in the form of fructose. Almost all patients tolerated it well; only a few with enzyme deficiencies did not. So, the scare-mongering about table sugar leading to liver cirrhosis is undiluted nonsense.
Hi Michael,
I’ve always enjoyed your comments on this and other threads.
Are you, perchance, the same Mayo Clinic trained–Rochester, MN–Michael Palmer I did my residency with?
Regardless, all the best
RG
Hi Robert,
thanks. No, I’ve never been to Rochester. I’m an MD by training, though, now teaching biochemistry in Waterloo, Canada.
Reply to Michael Palmer ==> Thank you, Dr. Palmer, for your participation here today.
Yes Michael Palmer it is a long journey. It takes decades to develop which is a time scale people fail to assess risk for. Liver damage is a two hit process. The fat makes the organ vulnerable to insults a normal one would manage and fibrosis results. You are correct that a healthy liver is well equipped to process fructose until it is not. The research that explains undiluted nonsense is readily available though I imagine a phrase that strong was just a momentary lapse in an otherwise calm thread.
Wayne, fatty liver is related to total calorie overload, not one isolated nutrient.
You may have heard of the practice of “noodling” geese or ducks. “The feeder sits on a box or stool … grasps each goose in turn holding it between his legs to keep it from struggling as he stuffs it with noodles.” Those birds famously develop fatty liver (“foie gras”), and it’s all caused by starch, not fructose.
Otherwise calm thread, huh? Calm or not, this thread is full of nonsense. Your comment is in good company.
It’s not about the sugars. It is about the carbs. Fat tends to turn off the appetite which is one reason you are always hungry on a low fat diet. Food pyramid and federal dietary guidelines that came in during the 1960s were the current fad of the time. After 50 years, it turns out to horribly wrong. Gary Taubes goes back to the future with his “Why We Get Fat, and what to do about it”. Contains anti-obesity dietary guidelines used medically prior to the 1960s. Worth a read. Cheers –
https://www.amazon.com/Why-We-Get-Fat-About/dp/0307474259
https://www.youtube.com/watch?v=ZwX8Ip_RAq0 agimarc If you like Taubes as I do you will like Noakes
So what evidence is there that 50 years from now all of this will be declared completely wrong? None—we know no more than we did 50 years ago, and quite probably less. As for why we get fat, too many calories taken in in proportion to those burned. That’s how it works. It is supposed to be a zero sum game. It really is that simple.
(A healthy diet is a different issue. Coke, candy bars and cheese can be eaten in quantities that don’t add pounds, but that’s a different issue.)
If I had three wishes, the first of them would be that people who need to proselytize would focus their attention on matters of religion and leave other peoples’ food out of it.
Weight statistics, including obesity, in America, are completely made up. There are annual phone surveys where tens of thousands of people are called and asked their height and weight. Self reporting. No validation.
THEN . . . the government employees adjust the data, based on what ever criteria they wish to use. Government employees whose jobs depend on finding a problem so they can keep their jobs.
In other words, there is no data that meets even minimal scientific requirements.
The Obesity Problem is just noise.
Lol- the defense pleads ‘TWINKIES’
Two independent relevant observations.
1. With respect to development of insulin resistance and its evolution into type 2 diabetes, there is a considerable body of research showing that the problem is exacerbated/directly caused by bloodstream dose concentration swings. T2 diabetes used to be exclusively adult and was called adult diabetes, distinguished from type 1 which is autoimmune related and is almost always juvenile onset and used to be called juvenile diabetes. The prevelance of type 2 in under 18 has grown from near zero 30 years ago to about 20-50% of all juvenile diabetes (race dependent). That is directly attributed to sugered soft drink consumption.
Glucose digested from Carbohydrates like whole grain bread or pasta take longer to reach the blood stream and produce less of a glocose spike. A liquid sugar bomb produces a large rapid spike that taxes the islets of Langerhan which produce insulin in the pancreas.This is the essence of the 2 hour clinical glucose tolerance test. Fast 2-4 hours, take blood glucose and insulin. Drink specific sugar bomb. Take blood glucose and insulin at 30 minutes and two hours. That is yhe definitive diagnostic for the presence and degree of insulin resistance, relevant for dosage levels of drugs like metformin. Other common interventions include exercise, weight loss, and reduction of sugar intake, which can reverse most mild to moderate IR and eventually eliminate the need for drugs. Severe IR usually progresses to T2 diabetes. Drugs like metformin can slow the progression and extend the time before injected supplemental insulin becomes necessary.
2. It is said HFCS is somehow bad. Ignorant ‘science’ like in climate. Table sugar is sucrose. When ingested, it hydrolyzes with water to produce 50% glucose and 50% fructose. High fructose corn syrup used in soft drinks is actually HFCS 55, 45% glucose, 55% fructose. Essentially no difference metabolically. It tastes sweeter than sucrose, so less is needed for comparable taste sweetness. That is good on the margin if one is trying to reduce calories. Better to eliminate soft drink sugar bombs period.
Reply to ristvan ==> It is true that there is research that seems to implicate excess sugar in the diet to Type 2 diabetes, but it is far from proven and is very controversial. There is a great deal of research effort trying to prove that sugar in the diet causes diabetes, but after many many years (and billions of dollars spent) such proof has not been forthcoming. It may not be there at all.
The “links” between diabetes and sugar are hard-wired by biology. The causation of diabetes is not.
Time will tell — but I doubt that the outcome will be “excess dietary sugar causes diabetes”. (with the possible exception of some sub-set of humanity genetically so inclined.)
Yes, we are going backward in our understanding of diabetes. Originally, the belief was sugar caused it. Then an enterprising person figured out insulin had something to do with it—or more precisely, the lack thereof. Then came T2 diabetes and sugar was again brought in as the boogeyman causing the condition. I hope fewer people die due to this belief than died of type 1 before it was understood that it was not sugar consumption, no matter how much it looked like it was.
‘there is a considerable body of research showing that the problem is exacerbated/directly caused by bloodstream dose concentration swings.’
Volume doesn’t make it correct.
Diet related health conditions are multi-factoral, take a lifetime to realize,
and are difficult to study and control. And there are multiple factors leading to
similar outcomes. Never the less, fructose is demonstrably difficult to
assimilate, demonstrably screws with hormones which regulate fat storage and hunger.
Given that diabetes costs $1000s of dollars out of pocket and has lots of nasty adverse effects,
( blindness, foot amputations, skin disease, et. al. ) avoiding fructose makes sense.
You will still eat some ( there’s some amount in broccoli ), but cut out the sodas and candies.
Article fails to discuss metabolic pathways.
Article fails to even mention the word fructose.
Article fails to mention insulin, much less leptin, grehlin, etc.
Article fails to demonstrate the change in sugar consumption over time.
More science please.
Prof. Tim Noakes – ‘Medical aspects of the low carbohydrate lifestyle’ https://www.youtube.com/watch?v=fL5-9ZxamXc
The only reason we are having these arguments is because most of the epidemic diseases, infections prior to the discovery of antibiotics, improved sanitation, and safe drinking water allow us to get old enough to die in our eighties from nutritional imbalances.
The reason the Social Security retirement age of 65 was chosen in 1935 because the average life expectancy for men (born in 1930) was 58 years and women had an average life expectancy of 62 years. I wonder how much refined sugar was in their diet?
Yes, and they weren’t sedentary.
Baloney, MikeC. Up until the 1980’s, there were no gyms, no “workouts,” no one jogged, ran or walked if they had a car. Men worked in offices or factories; women stayed home and did housework. After hours they read the newspaper, talked, socialized. Only THE POOR, who are known to have the WORST health, were doing heavy manual labor for hours every day, like materials handlers and field hands. “Sedentary” is a pejorative term taken to mean “idle,” once again we are in the realm of Secular Virtue. What are they trying to “legislate” via health? You got it: Sloth, gluttony, drunkenness, low productivity!
Life expectancy is a stat that most people tend to misunderstand. This number is an average and is significantly swayed by infant mortality. It doesn’t take many Age 0 or 1 deaths to skew an average way down. We do a lot better nowadays with infant mortality and not surprisingly, life expectancy has increased. But because it’s simply an average you can’t take it to mean that people are living longer and more importantly, with better quality of life.
Carbs do stimulate more insulin and don’t take many calories to digest. But this study of long ago demonstrated that a high carb diet was better than a high fat diet wrt blood sugar and intramyocellular lipids.
Fats don’t stimulate insulin as much, and take a lot of calories to digest, but may lead to insulin resistance.
Proteins don’t stimulate insulin much, provide energy, and take a lot of calories to digest, but too much is hard on the kidneys.
Vegetables provide nutrients, contain fiber, but plants only defense is chemical. The same source of necessary nutrients is full of toxic and cancerous components life long.
Fiber slows digestion and burns calories, slows the ingestion of the contained carbs, and speeds bowles.
But too much can also cause problems.
All foods are bad ( though fructose does probably deserve a place in hell ). The key may be limiting load and fasting more.
People talk about paleo diet and think eating more meat.
But humans of evolutionary past probably went days without finding anything to eat and our bodies are evolved for that reality.
Eat a lot more nothing for your health.
Surely there must be state AGs chomping at the bit to pull a RICO on the sugar industry.
Carbon free sugar. A Limerick.
The Settled Science of Carbon Pollution has reached a new level. Now there is certified carbon free sugar.
Rejoice, diabetics, hear hear!
The Carbon free sugar is here!
No more Splenda for me
I’ll take sugar in tea
It’s Domino’s sugar this year!
(Disclaimer. Maybe, just maybe that is not what they meant?) https://lenbilen.com/2016/02/26/4707/
It figures that they now are at war with sugar. The medical industrial complex is like a yo-yo dieter. They go from one fad to another. The author’s key insight: Sugar isn’t inherently bad, it’s the amount that makes it unhealthy.
I absolutely love the article and the point it makes as well illustrated by the comments that follow. One would expect that basic nutrition would be one of the least controversial subjects, however as demonstrated here and so many other places… nutrition is hotly debated and more polluted with nonsense than just about any other subject.
Unfortunately, or fortunately depending on how one looks at it… the true believers in whatever crackpot idea is in vogue get to experiment on themselves. Most, however talk a good game, but just eat whatever they feel like. Do you remember the Junk Food Junkie comedy song by Larry Groce from the 1970s.
https://youtu.be/jQnIL-XPerQ
I hope you’ll also be blogging on dose-response. It’s beginnings with threshold. The rise of linear no-threshold, LNT. The current uncivil war between radiologists and the gate-keepers of LNT. Hormesis and its connection to a decades long research into nature’s cell and DNA repair mechanisms. Three scientific models. One could write a book on it. It’s so shot full of politics and do-gooders, I bet they already saved the world 3 times over in their heads.
The commonality on these science wars is the “warriors” are taking immensely complicated subjects & boiling them down to a few sound bites to support what they “feel”. The more I learn about human biochemistry, the more I skeptical I am about any claims that something is good or bad for you. The systems is just too complicated with too many variable inputs to make simple & sweeping statements. A couple thoughts :
• That being said, “everything in moderation” is probably a good place to start.
• As an athlete, I know sugar effects my performance in different ways in different situations – sometimes for better, sometimes for worse. So the subject for me is not black & white & I would not be a “warrior” for either side. Self-awareness and self control are key .
Its even more complicated, as individualized medicine is starting to learn. There are naturally fast and slow metabolisms. Metabolic rate can be reset with diet and exercise over time. There are natural fast twitch and slow switch muscle fiber predominent body types. Fast twitch football and basketball players, slow twitch distance runners and swimmers. There are genetic disease predispositions like BRCA1 and BRCA2. There are statistically quantifiable racial group predispositions, like American Indians to diabetes, African Americans to (salt) hypertension, and Japanese to stomach cancer (maybe diet also, but same is true for Japanese Americans).
When it comes to nutrition, it pays to remember there are blue, green, and brown eye irises.
A lot of nutritional fads are pure bunkum. Gluten protein is neurotoxic is my favorite. One less one has celiac disease, gluten protein never enters the bloodstream. Digestion breaks protein into its constituent amino acids; it is those that are absorbed and transported. A lot more is just placebo effect, as with many (but not all) health food supplements.
Reply to Jeff L and ristvan ==> If you haven’t yet read The Rightful Place of Science: Science on the Verge, I recommend it (it is not for the timid). Available free or almost free from the Big A.
If sugar and other refined carbs are so good for us, why is it that when we eat them our teeth get covered in slime that then turns to hard plaque, which then leads to gum disease and our teeth falling out? We can eat fat and protein all day without building up plaque on our teeth. Clearly our ancestors weren’t eating a high carb diet, else they would have evolved with oral chemistry that handles it. Why grow teeth if your diet only results in those teeth falling out? Natural selection ought to have weeded out carb eaters long ago as we’ve only had dentistry in any form for a few thousand years.
Because plaque tarter is actually a calcifying biofilm made by mouth bacteria who feed mainly on carbs. Archeologists use ‘fossil’ plaque to estimate foods consumed by hunter gather ancestors. Gathering seasonal nuts, fruits, berries, and grass seeds was part of homosapiens lifestyle way before agriculture was invented and cereal crops were developed through selection.
Reply to anarlib ==> Our family dog gets plaque on her teeth and the vet scrapes it off. She doesn’t eat sugars or refined carbs.
Reply to anarlib ==> Our family dog gets plaque on her teeth and the vet scrapes it off. She doesn’t eat sugars or refined carbs.
Are you sure?
Most dry dog foods contain grain meal and many contain sugar in one form or another.
And check the label. They’ll tell you percentage fat, protein, fiber and water, but not carbohydrate ( which, presumably, is the remainder ). Wonder why. Perhaps marketing to make you think it’s healthy.
The percentage carbohydrate on many is around 45% – probably not good for the dog,
but a trade off between price and nutrition.
But I’ll bet she eats kibble, and that’s grain-based; not a canine’s natural diet. I keep my pack of five’s teeth plaque-free by letting them chew big cow bones fresh from the butcher a couple times a month; they literally disappear under that immense jaw strength and equally astounding stomach acid! Putting a dog “under” for teeth-cleaning I’ve always thought was unjustified; but then, my guys live outside! 😉
My dogs eat meat, eggs and offal – they have brilliant white teeth with no plaque. I wouldn’t let them eat something I wouldn’t eat myself. Dog and cat kibble is pretty terrible, it’s full of crap that no animal in it’s right mind would eat in the wild. And that’s why you never see animals in the wild that are obese but it’s commonplace with our pets. The food most of them are fed does horrible damage to them.
Reply re doggie dental plaque ==> The subject is controversial, even among vets (who may offer teeth cleaning services and thus may be biased by the profit motive — this is not an accusation, vets, so no flaming, please). (Hardly on topic though…)
The American Vet Assoc says “Several “dental diets” have been shown to be of benefit in decreasing dental disease. Some employ a specific kibble design and others include a chemical anti-tartar poly-phosphate ingredient. Rawhide products and chew treats can be helpful if chewed daily, and some rawhide chews and biscuits contain an anti-tartar ingredient. Palatability is important – chewing every day is the ideal.”
Another site praises the value of raw meaty bones.
A third says “Studies show that hard kibbles are slightly better than canned food at keeping plaque from accumulating on the teeth. There are veterinary dentist-approved foods and treats on the market that have shown that dogs eating these foods have less plaque and tartar build-up.”
Take your pick.
Generally, as a past pet professional (breeding, raising, and retailing), my opinion is that feeding and care of pet dogs (house pets, lap dogs, kid’s dogs) varies from that of working dogs — and each have their own best practices. I fed raw bones as part of the regular diet of working dogs with good results. Our house dog, a lovely little Basenji named “Jude”, received high-grade kibble intended for smaller dogs and proper chews for dental health, with good, but not perfect, results, albeit she has never had any dental or gum problems.
Obese pets certainly may be so because of the ingredients in processed pet chow. However, its more likely due not to content, but due to the amount they consume. Wild carnivores never become obese because of intestinal parasites, disease, missed meals, inter and intraspecies competition and the obvious caloric expenditure associated with chasing and killing each meal.
https://youtu.be/dBnniua6-oM?t=1m5s
Kip Hansen
Thank you for your efforts to inform instead of inflame.
As you are probably aware, the publicity and policy makers’ alarm regarding obesity and the associated increase in sugar consumption began in earnest at the stroke of midnight, January 31st, 2000. That was when the measure of body weight vs height, the Body Mass Index (BMI) became standardized globally. In doing so, specific cutoff values were made and agreed upon. The data of weight, height and blood pressure was accumulated since 1971 and reported as the the first National Health and Nutrition Examination Survey (NHANES), with the surveys becoming an annual event in 1999 and the first report on the topic published in 2001.
Influential policy consultants set the goalposts, not quite in keeping with the data. Instead, the normal BMI became 25 became were characterized as “over weight”. A BMI of 30 became obese when the data said 33+ and so on. The metabolic syndrome, diabetes, hypertension were recognized as issues for people with BMI 40+. In addition, the data said that people with a BMI >27 and <34 lived longer than those with BMI <27. The Obesity Paradox was created by moving the goalposts 2+ points downward.
The sugar story, and the high glycemic index foods; i.e., those foods high in sugar, rapidly absorbed causing a spike in blood sugar and an insulin response that shepherd the glucose into cells to be made and stored as fats, are part and parcel of the grain foods we eat, bread, bagels, and pasta let alone the sodas etc. All sorts of fad diets were manufactured with the premise that grains are good and fats are bad, all except Adkins of course who died of a head injury from falling on ice on the sidewalks of NYC.
The Sugar Wars really need to include eliminating breads, bagels, pasta, and all but the indigestible grains if we really are going to deal with the obesity epidemic. Or, we could of course, revert back to the recommendations of 6 people, way back in the 1941, charged with making nutrition recommendations for a nation on a war footing, studied the literature and came up with the Recommended Daily (or Dietary) Allowance (RDA).
A balanced diet: 1/3 calories from carbohydrates, 1/3 calories from fats and protein, 1/3 calories from fruits and vegetables. Still good today as yesteryear. Try it, you'll like it.
Reply to RiHo08 ==> Thank you for your support. My favorite diet advice was given by a man who I knew personally and who was a “functioning psychotic” (don’t ask).
Here it is: “Eat your chow!”
My wife and I recently returned from a ten year stretch of humanitarian work, mostly in the Dominican Republic — mostly with the profoundly poor — where the concern was having something to eat..
All the hub-bub here is from people who have [almost certainly, always exceptions] never been truly hungry due to lack of food.
I would guess that 80% of the world’s population are not concerned with what they eat, but with the question “Will I get enough to eat today?”
“1/3 calories from carbohydrates, 1/3 calories from fats and protein, 1/3 calories from fruits and vegetables”
The calories in fruits and vegetables are also carbohydrates (mostly), proteins, and fat. They are not a separate category. So, this “recipe” is a bit vague.
Michael Palmer
The glycemic index for broccoli is 15
The glycemic index for whole wheat bread is 71
Eat your vegetables.
The above article is completely incorrect. Hansen’s and most of the general population’s ideas concerning nutrition is based on urban legends such as the assertion that ‘all calories are the same’ which is absolutely incorrect.
The diet urban legends are and were created by the Food ‘group’ industries (to protect their food group’s market share, such as the get cracking, egg ad campaign which the FDA was forced to stop, consumption of 2 1/2 eggs a week results in a 81% increase in lethal prostate cancer for example), the ‘Dieting’ industry (the solution to obesity is a change in diet not caloric restriction, dieting) and the ‘Diet’ industry (For example the Paleo diet is not the optimum diet based on three decades of research.)
The optimum diet (based on three decades of research) for humans reduces the risk of all of the common cancers by roughly a factor of 4 and is the ‘cure’ for most of the Western diseases such as metabolic syndrome. How is it possible that the majority of the population is clueless about how diet affects health?
The consumption of industrial sugar, alcohol, and/or fruit juices (consuming whole fruit is completely different than consuming fruit juice) is the primary cause of fatty liver disease which inhibits the normal functioning of the liver which causes a number of health problems including high blood pressure and excess sugar in the blood (due to the fat in the liver, the liver’s response to insulin is reduced which causes excess sugar in the blood stream). Fatty liver disease causes a multitude of health problems and will eventually lead to liver damage. This set of health problems caused by diet is called metabolic syndrome.
This is a link to a site that provides an excellent holistic in depth review (explains for example how the researchers test different hypotheses) of the most current nutritional/heath research.
The information is presented in short 4 to 7 minute videos with links to the new and old peer reviewed papers (that support the video summary, with quotes and data from the paper in question) explaining how the theories have changed or not changed.
The “twin vicious cycles” explain how the buildup of fat in the cells of our muscles, liver, and pancreas causes type 2 diabetes, which explains why dietary recommendations for diabetics encourage a reduction in fat intake.
http://nutritionfacts.org/video/diabetes-as-a-disease-of-fat-toxicity/
http://nutritionfacts.org/video/eggs-choline-and-cancer/
http://nutritionfacts.org/2014/08/21/why-the-egg-cancer-link/
How much whole fruit consumption is too much?
http://nutritionfacts.org/video/how-much-fruit-is-too-much/
This is a link to a couple of additional papers that deal with the issue of fructose in the diet.
http://www.ncbi.nlm.nih.gov/pubmed/22129639
http://www.ncbi.nlm.nih.gov/pubmed/20368739
It is interesting that the researchers have worked out many of the mechanisms which explains why diet is responsible for roughly 70% of all Western diseases. This is a link to a one hour presentation that explains the research to support that assertion.
This is a great starting point to understanding what is or is not the optimum diet and to understand the mechanisms.
http://nutritionfacts.org/video/uprooting-the-leading-causes-of-death/
Sorry William but all calories ARE the same. A calorie is not a physical thing, it is a unit of energy measurement, it describes how much energy your body could get from eating or drinking. All the other factors of how certain foods act in the body of course come into play but a calorie is a calorie is a calorie.
I think this is an important semantic issue that causes a lot of needless argument.
One calorie equals one calorie. As you say, it’s a measurement of energy.
But food of type A with a calorific value of 1 is NOT equal to a different food type with the same calorific value.
MIke, I think you are adding to the confusion with “caloric value”. Because calories are a unit of energy, you can compare energy values but not food types. For instance, 100 calories of lettuce compares energy wise with 100 calories of butter but obviously the amount you would need to eat of each to attain those calories is vastly different. Calories are simply a way to measure energy in and energy out. But that does not do much to explain where the calories are coming from or the other factors from the type of foods eaten that influence overall well being.
that isn’t the entire story – as you will learn when your glucose tests come back warning you of diabetes
sorry if that ruins your analog to CO2 – but CO2 is nowhere as pernicious as sugar – you made an unfortunate choice of topic
the diabetes threat is real – http://www.diabetes.org/diabetes-basics/statistics/?referrer=https://www.google.com/ – i used to be as blasé as the author – but as a pre-diabetic – i no longer am
Reply to JEyon ==> Thanks for the free medical opinion. However, I have been getting regular blood work annually since I passed 60, most recently four days ago, and do not suffer from blood glucose problems — neither high or low — nor do I have any form of diabetes, not even the newly invented “pre-diabetes.”
Hi Kip, you put a lot of effort into your post and when I was your young age I would have probably agreed with all of it. I had never had, nor have I yet 5 years later, had a questionable blood test. However, I did learn to my dismay that I had joined a surprisingly large number of people diagnosed with cirrhosis with no prior warning after carefully building a fatty liver for decades. As someone in the actual battle my advice is not to take too much comfort in that blood work. I’m a technical person so research is second nature to me and I can assure you that the state of evidence doesn’t exonerate sugar as a dietary hazard. The process is vastly more complex than a discussion of glucose and a climate blog is an odd place to have this thread. In simple terms however, minimizing saturated fats and sugar will be beneficial for your liver and overall health. Obesity is epidemic and the damage isn’t only that you have to buy bigger clothes.
Reply to Wayne Eskridge ==> I hope you have read the entire essay. If you missed it, I am over 65 and retired after a very active life. I am sorry that you have been diagnosed with cirrhosis.
I have not said that morbid obesity is not a health hazard.
Read the last link in the main essay [ link ] . It is the latest topic-wide meta-analysis of research on dietary sugar.
The Conclusions starts with this simple statement:
“There are epidemiological data, plausible mechanisms and clinical data from diet intervention studies that provide strong support for a direct causal/contributory role of sugar in the epidemics of metabolic disease, and for an indirect causal/contributory role mediated by sugar consumption promoting body weight and fat gain. Yet, these are still controversial. ”
The posited causal/contributory roles are based on the relationship between sugar and obesity for the most part — yet the strongest statement that can be made is “strong support”….the authors don’t even find that sugar a direct cause of weight gain or fat gain — only “strong support” for an indirect causal/contributory role.
That is weak evidence indeed.
You’re making the assumption that a fasting blood glucose under 100 is a sign of health, it’s not. Your fasting glucose can be “normal” but the problem is that blood glucose can take a decade or more to show up after metabolic issues arise. I find that Dr. Joseph’s Kraft’s work on insulin is much more telling when it comes to being a diabetic as insulin is a leading indicator, unlike blood sugar. I hate to put it so baldly but your coronary issues indicate you have serious metabolic issues.
A writeup of Dr. Kraft’s work can be found here:
http://www.thefatemperor.com/blog/2015/5/10/lchf-the-genius-of-dr-joseph-r-kraft-exposing-the-true-extent-of-diabetes
kip – glad you are still diabetes free – but a lot of people aren’t – and no one should base the global situation on any one person – (like I shouldn’t have based my prediction of your health on mine)
never the less – i still contend that your CO2 / sugar analogy is a false one – unless you’re willing to admit that more CO2 is dangerous to some people but not others (a not too unreasonable assumption – i suppose)
Reply to JEyon ==> What “CO2 / sugar analogy”? There is no mention of CO2 anywhere in my essay (I know, I wrote it) and there is no point made meant to be taken as any sort of comparison of the details of MSC (controversy) regarding sugar with the MSC over Climate. Have you carefully read the essay? and the two preceding essays in the series? You are the only person who has mentioned CO2 here today — including in ALL of the comments — I am somewhat flummoxed as to how you arrived at your idea that some analogy was being made between CO2 and Sugar.
What this series of essays is about is Modern Scientific Controversies (MSC), which Kahan has recently been calling “The Science Communication Problem” (see the prologue at the beginning of the essay),
By researching and writing about a number of MSCs, I hope to illuminate the common factors shared between them. Why? Simply because these MSCs harm the reputation of science and prevent the communication of good science to the general public.
kip
indeed – you didn’t mention CO2 – it was my mistake to think that on WUWT – you used an anlalogy to sugar to demonstrate the fallacies used by the Alarmists
maybe it’s statements like “The proponents of the War on Sugar – those fighting to eliminate — or at least sharply reduce the amount of – sugar from the American diet have painted sugar as bad – have made sugar into a villain” that fooled me since substituting “CO2” for “sugar” would work really well
If you’re asymptomatic, STAY AWAY from doctor visits for “drawing blood” for the purpose of speculative “diagnosis,” aka lifting up rocks to try to find “disease” or “pre-disease.” NO DOCTOR = NO PROBLEM!
Most of this crap is nothing but a cultural construct to make MONEY.
I know a lady who thought that way. She is now losing her sight due to untreated diabetes.
Ah, yes, the ubiquitous Scary Anecdote! Sorry dude, no sale. I’ve worked with animals my entire life enough to know that when the body, man or beast, has a serious problem afoot it generally lets you KNOW. Google the symptoms for Type II diabetes, and the risk factors–which are mostly genetic.
Generally speaking, the 80-15-5 rule holds sway: 80% of the time everything’s fine pretty much no matter what you do within reason. 5% of the time Nature calls your name and it’s game over regardless. Only 15% of the time is what you do, when, and how really a game-changer.
I’m not a big believer in the boogeyman known as The Silent Killer . . . but it makes great marketing of fear.
One final comment that applies to things like salt and sugar. Individuals differ. A lot. Some people are born diabetic. Perhaps dietary excesses of one sort or another cause some folks to develop metabolic disorders like diabetes. And in all likelihood, some people are genetically programmed to develop problems like diabetes,strokes, heart disease as they age. One size fits all dietary “solutions” probably won’t work except for some population subsets. If they work at all. For anyone.
I bet all the people who died from high blood pressure, undiagnosed diabetes, etc, all said the same thing. It’s fine to have screenings for problems. You don’t have to do what the doctor says (assuming there is a doctor involved—some places screen without involving a doctor) if you don’t want to. You can research the condition (hopefully using actual research and not internet blogs_ and decide what to do. You may believe ignorance is bliss, but that’s only until it kills you.
In some ways, this piece is correct.
People like a single factor cause when multiples are at work.
People in the 1800s did manage to get fat without access to all the sugar we consume today.
And diabetes is written about through out history.
However, there are good reasons to believe fructose is a large factor ( not the only factor, but a major one ) wrt to fattty liver disease and ultimately diabetes.
Wrt global warming, there are industry bugaboos:
Ancel Keys was funded by the sugar industry to say fat was the cause of heart disease.
But Ancel Keys also distorted the science and bullied his way into organizations, similar to the IPCC.