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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Correlation is not causation.
But we should still pay attention to it and consider why something else is more relevant.
http://www.tylerpenn.net/wp-content/uploads/2016/01/F1.large_.jpg
Today is beer day.
I’ll still have one, but only one, because alcohol metabolism appears about the same as fructose
http://65.media.tumblr.com/dc7fd65546bbb27f348a92efe2062749/tumblr_inline_o5gci0ZpFg1sav5xu_1280.jpg
http://www.nofructose.com/wp-content/uploads/2013/03/Fructose-liver.jpg
Hi Eddie, your fundamental interpretation is on target. Anything that leads to inflammation, as both alcohol and fructose do, have the potential to kill liver cells and if the concentration exceeds the liver’s capacity to clear the brewing fibrosis the path toward liver failure is traveled a bit further. The liver has an amazing repair capacity but we can certainly defeat it and there are few warnings prior to serious damage.
There is a j curve relationship between alcohol content and all causes of mortality after 20 units approx per week for men it starts to go up before that it goes down. There was a big debate recently in the uk when the recommendations by the chief medical officer went down from 21 to 14 units per week for both men and women. The potential result? Well, total credibility wipe out. In five years it will also be zero units.
Once again, they are now trying to regulate via “health” the identical behaviors (i.e., drinking) that were once under the MORAL rubric of The Church. Sloth, gluttony, intoxication, sexuality. “Health” is the new, secular, Church of Immortality. The extent to which otherwise intelligent people have swallowed this wholesale continues to astound me! Just like the High Church of CAGW!
This stuff ( hyperbolic rhetoric ) is justified though by these same hysterians claiming that they need to exaggerate in order “meet in the middle” I hear that crap over and over again no matter if it’s our diet, the climate, or whatever. When pinned down with facts the response is always the same, ” I know but if we don’t get people’s attention nothing will change.”
So don’t look for any changes soon. Lies and exaggeration are deemed righteous.
I believe that some of the concerns about the sugar content of the modern diet are justified.
The increases in obesity and related diseases does correlate with the increasing sugar content. I agree causation has not been confirmed.
The “low-fat” fad has also led food processors to add large quantities of refined sugars to many foods.
There is some evidence that sugar may be mildly addictive.
For myself, I have sought to cut back on foods with added sugars, and increased the quantity of fresh fruit I consume (dramatically). I have lost weight, feel enormously healthier and my Doc is thrilled with the impact on my blood work.
But I completely reject the need for a “war” on sugar and most of the rest of the mainstream media hype surrounding sugar and diet in general. I do believe that eating less refined sugar and more fresh fruit is something that would prove helpful for the vast majority of Americans. Having said that, I passionately believe these decisions belong to the individual.
We don’t need no stinking soda/sugar tax as a means for the elites to take our money for themselves while professing to “help” us.
Reply to Mike Smith ==> There is always some justification for most public health ideas. The 350 lb. diabetic truck driver who stops at a truck stop for a 64 oz. carry-out cup of full-sugar soda six times a day really ought to cut back on his added-sugar intake.
The idea that sugar is addicting is nearly utter nonsense and is based on the mostly false ‘science’ of functional MRI., which has been found to have a error rate — false positives — of 70% — on top of the usual study design flaws and “finding what we are looking for” bias.
If you haven’t been eating your fruits and veggies, starting to do so will improve your blood tests. If you were eating Snickers as a treat and switched to an apple as a treat, you haven’t gone wrong.
I personally doubt that manufacturers are to blame — not for adding salt, not for adding sugar.
Opinions vary wildly. The science is still very uncertain — you can bet the farm that no single substance is to blame for any of it.
Your grandmother was probably right — eat everything on your plate (she meant a well rounded diet, spinach and all, fruit pie for dessert, because that’s what she was providing.)
Perhaps you could provide the health evidence for the so called 5 a day campaign, there is none of course. Also fruit and veg are different foods. Interestingly people eat more fruit as it preferred to e.g kale but it’s still part of your 5 a day. I haven’t eaten fruit for two years, well Goutboy says it all!
Just to say I would have thought the sat fat wars were a better bet much more evidence, much more intrigue, longer time, relates to big pharma re cholesterol. Sugar wars are just a side battle it might get hotter but not for some time, not while cholesterol still to blame for cvd and a replacement for statins is being pursued. I also think the parallels between the global warming nonsense and cholesterol are obvious. I think it was yourself who said that without the humble beginnings through the Internet there would be no debate on AGW. The same goes goes for cholesterol and cvd. All power to the blog.
“Your grandmother was probably right — eat everything on your plate (she meant a well rounded diet, spinach and all, fruit pie for dessert, because that’s what she was providing.
My grandmother, a nurse, died from Type II diabetes, but only after going blind and having several amputations.
Reply to Bob Johnston ==> Sorry about your grandmother.
It is an oddity that if one drives by a modern hospital, one can still see nurses out behind the hospital, smoking cigarettes on their breaks. Being a medical professional doesn’t automatically mean one will chose healthy life habits.
One of mine was a Wisconsin German dairy farmer’s wife and served four meals a day to the family and farm workers, lived into her 90s. The other was a Baptist missionary’s wife — round as a butterball and lived happily into her late 80s.
My point was simply that Grandma’s bromides should be taken with a grain of salt rather than a guideline for how to live our lives.
I recently went to the emergency room for treatment of a deep laceration, I wasn’t surprised to see that every single nurse in sight was grossly overweight. Quite possibly it’s an effect of shift work under “blue light” but I think it highly likely that it’s because they actually do follow the government advice to eat low fat and a large dose of whole grains. Just a hypothesis, but it would be a really interesting study.
And while I’m at it I think I’ll share my personal story here:
Ten years ago I wasn’t a critical thinker, I believed that “the experts” had it right. I didn’t know the difference between an observation study and a randomized clinical trial, the difference between absolute risk and relative risk or anything else necessary to determine the relevance of scietific endeavors. The housing crash cured me of that, all the experts said prices could keep on rising but being in the homebuilding industry and seeing how people were actually “affording” these homes made me understand just how FOS these experts are. That led me to wonder what else my faith in experts was leading me down the wrong road.
At the time I was 30 lbs overweight, asthmatic, was near-sighted, had hand tremors and hayfever and this despite eating a low fat, low sugar diet full of “healthy” whole grains. Why was I sick and getting worse if I was eating healthy and exercising (weight lifting and mountain biking). I had lost weight before using a low carb diet but because all the experts said it was unhealthy and I didn’t want to become a slender corpse I switched back to the very diet that found me fat in the first place (yes, I was that dumb).
Ten years of study has led me believe that nutritional science is just as effed up as climatology, it’s rife with cognitive dissonace and confirmation bias and why wouldn’t it be? Researchers are generally smart people and the smarter you are the more susceptible you are to falling for the notion that a belief you hold cannot be wrong. And this showed up time and again in the studies promoting a low fat. high carb diet as the way to eat for good health. Low carb diet studies time and again show them superior to for weight loss and risk factors. But these get ignored because people are unable to change their minds.
Today I am not overweight despite never counting calories. I eat when I’m hungry, I just don’t eat foods (hard to call them that) that I know will cause an insulin response. I am no longer asthmatic, my hand tremors are gone, my vision has improved to the point where I tossed my glasses (actually the dogs ate them and I never replaced them) and I don’t suffer from hayfever anymore. A miracle? No. Just a simple change in diet that reduces insulin production. A year ago I had lab tests done (you can get them done directly with online labs rather than see a doctor, they’re quite cheap this way) and the results are pretty darn good if I say so myself:
Triglycerides – 55mg/dl
HDL – 66 md/dl
Fasting insulin – 6 (I forget the units)
Fasting blood sugar – 83 mg/dl
These are the marker si think are important, both total cholesterol and LDL-C aren’t very predictive markers at all – mine were normal (although LDL-C from a basic lipid test is wildly inaccurate when triglycerides are under 100 or over 400 because it’s calculated using the Friedewald Equation rather than actually measured) so I really don’t know what my LDL-C is, and don’t care anyway.
Sure, I understand this is just an anecdote but what’s funny is that it becomes the same anecdote for everyone who I convince to try a low carb diet and intermittent fasting. But it is what it is.
I’m not sure what the point of publishing this article was.
I don’t want sugar or anything else banned/taxed/demonised but if you eliminate or minimise GPS (grains, pototos, sugar) from your diet you will lose weight. My wife (former RN) has done considerable reading on the subject. It seems clear that Ancel Keys was a charlatan in his demonisation of saturated fat.
Dr Lustig gives you the clues about fructose in his video linked here by a couple of commenters.
Run the experiment. My wife and I have for the last two years. We never were fans of sugar but did like pasta and bread. Cut that out and I lost 10 Kg (77 kg down to 67 Kg), she lost 3.5 kg (53 Kg down to 49.5Kg). Blood work shows slightly higher total cholesterol but high density up, ratio of high to low much better, triglycerides down, fasting blood sugar completely normal. I’m not going to argue against experimental data.
If you were reading Karl Denninger at http://www.market-ticker.org/ before it went black you’ll have seen lots of similar stories. Likewise read Dr Malcolm Kendrick.
Looking at what waddles around supermarkets nowadays and looking into their trolleys when they are in front of you in line at the checkout should give you a good clue about sugar and getting fat.
Sorry about the typo in potatoes. Also you can still find the low carb stuff on Denninger’s site.
Reply to Mike Borgelt ==> Thank you for sharing your personal experiences with weight loss. The weight loss world is filled with similar anecdotes — using hundreds of various and different specifics. Your story is that you and your wife lost weight by cutting bread and potatoes. Well done.
My story was cutting restaurant food and sugared soda — repeatedly losing those extra 10-15 lbs.
The Obesity Wars are all about what does and does not work. You’ll see that there really is no single answer — we do not yet really know what causes obesity. There will be an essay in this series on the Obesity Wars.
Sugar, in the diet, after all the research done over the last twenty years, has only been found to be “supported” as an indirect or contributory cause of weight gain and fat gain. In other words, it hasn’t been ruled out, but it hasn’t been shown to be a primary cause either.
We think we know a lot, but we are actually staggeringly ignorant about how our bodies work, and about how varied the function is.
Otherwise it wouldn’t have been such a shock when a study centering around treating obesity and diabetes with a variant on gastric bypass mysteriously cured a number of patients of diabetes in Germany (research is ongoing, they don’t seem to know quite how they did it).
Not to mention genetics, epigenetics, gut flora, blah blah blah. Oh and my favorite Adenovirus 36.
Unfortunately, people tend to laser in on one subject (calories, fat, sugar, exercise, protein, etc) and since our general knowledge of the subject is based on oversimplifying an incredibly complex system (with the legitimate goal of trying to break a subject down into bite-size pieces than *can* be understood). That means our overall progress is painfully slow.
On top of that, people tend to “politicize” or “moralize” their ideas, too (conspiracy theories about marketing and government standards, blaming things on TV or laziness or whatever).
And on top of *that* somebody’s always trying to sell you on a miracle food or diet, either to make money or because “it worked for them” for whatever reason.
In the end, the average person is just surrounded by shouted contradictions and the average fat person is just discouraged because nothing seems to work (especially being shouted at).
Someday, provided we don’t all descend into Noth-Korean-Style prison-statism or nuke ourselves to oblivion, we’ll probably get a handle on the genetics, epigenetics, hormones, gut flora, and on and on that control why two people of similar builds can eat the same amount, exercise the same amount, and one is skinny and one is fat (yes it happens).
Until then, we’ll probably just fight endlessly and judge each other harshly, as per usual.
The anti-sugar activists could conceivably perform an experiment on themselves; they could give up their alcoholic beverages every night. Those are fermented with sugar. Then they can get back to us with their results, improvements in mental clarity, and weight loss.
Very nice article. Thank you.
Reply to Zeke ==> You are welcome. It is hard to write about these controversies without taking sides — I am usually only partially successful — and try to side with strict science.
Kip Hanson says, “…and try to side with strict science.”
I appreciate your rolling up your sleeves to do that, esp. with the wide reading and historical perspective.
What strikes me about sugar is its usefulness. Any one who has fruit vines and trees understands that you can only dry so much fruit. Sugar is a wonderful preservative for all the apples, figs, cherries and grapes that start getting ripe starting about now, plus some of the wild berries. It gets ripe all at once and the sugar and the canning process allows us to preserve it. Without this, there would be tremendous waste.
Sugar beets grow in the north well, and the pulp and tops are excellent feed for animals like goats and dairy cows.
Every loaf of bread requires about 3 tbs of sugar. Just a small amount can do wonders for a cup of coffee or tea, and of course there is the matter of chocolate. I suppose I have only scratched the surface but I do wish that people would remember to give thanks for food instead of getting so upset. It all just amounts to the power of negative suggestions.
[snip – policy violation, childish expletives -Anthony]
Calm down Brian, take your statins like you’ve been told.
The author seems not to be aware of two important ways the debate is even more insidiously fraudulent than he describes.
1. The “obesity epidemic” itself is non-existent, or greatly overstated. Body Mass Index was expressly stated by its creator to NOT be a gauge of health and/or percentage body fat. It does not differentiate between lean muscle and fat. There is no place for BMI in the discussion of healthy body composition. Stating one’s own BMI, as the author does, lends legitimacy to a false diagnostic.
2. The author has been trained in the falsehood that a high-sugar diet is “bad.” Read the CNN (and other) article regarding the Professor of Nutrition who went on a “Twinkie” diet of convenience store food and multivitamins and not only lost weight (as one always does when starting any new diet, because of water loss and attention to caloric intake) but improved his cholesterol profile. He demonstrates how little we understand our bodies’ real needs despite making endless pronouncements and rules.
http://www.cnn.com/2010/HEALTH/11/08/twinkie.diet.professor
Bonus note: In earlier times, sugar was demonized for causing children to become sexually aroused. There has always been a war on anything that tastes or feels good. Crazy has always been with us.
Otherwise, thanks for a good essay!
Common sense is your best friend. Of all the nutritionist hoopla, there is a single article that I can support and recommend, “Unhappy Meals” by Michael Pollan. Over 97% of the rest is garbage.
As for cavities, my 13YO son have grown into a healthy young lad with zero cavities and zero interventions on his teeth. We concluded that tooth cavities are a “hereditary” disease inherited by means of transferring parents’ saliva into a babies mouth. My teeth are a nightmare on Elm Street, my wife’s a zombie apocalypse, yet my son’s teeth are all healthy. And yes, he has LOTS of sugar every day.
Guess most of “genetically predisposed” diseases are also some kind of a parental transfer of pathogens, with zero involvement of genes.
For most of human history, fatness was not considered a negative trait. It was a sign of wealth; it meant your family could afford regular meals. The lean, hungry poor ate what they could grow, steal, or glean.
In our time, an ironic reversal has occurred in the West. Our poor can eat like kings and put some meat on their bones, while our rich all-but starve themselves on the latest fad diets and supplements to try and stay as lean as possible.
There certainly is a wonderful wealth of dietery expertise here, and people here are not only informed but very generous with their advice!
I could not help but notice that the discussion includes a particular emphasis on fresh fruits and vegetables. Fruits and vegetables have come up over 40 times on this thread. My opinion is that it is outstanding that Americans can all get these fruits and vegetables in season and out of season, in every part of the country, at an affordable price.
You’re welcome!
http://www.tractor.com/blog/wp-content/uploads/2012/02/John-Deere-Tractor-0215.jpg
Fruits are mostly fiber, sugar, and water. Vegetables are mostly just fiber. Our digestive system cannot handle cellulose, of which plants are composed, with the result that what comes out is pretty much like what went in. That’s your “5 a day!” THE POINT which the “experts” all keep dancing around since they can’t (economically and PC speaking) come out and say it is: ANYTHING you eat instead of refined, processed starches and sugars is likely to advantage your health! That would include wood chips if you could chew them! Believe it or not, one hamburger of even indifferent quality contains more essential nutrients, more antioxidants, more of every single building block the body needs than practically that whole truckload of “veg.” WE EVOLVED AS CARNIVORES during the big glaciations–can’t argue with evolution.
So I like to say I’m a second-hand vegan: Cows eat grass, I eat cows! 😉
In the USA cows eat mostly grains passing on this deadly omega 6 PUFA.
Reading through all these absolutely definitive statements on sugar, fructose, insulin, etc, I am forced to ask:
Why is there no perfect system for type 1 diabetics that keeps their blood sugars 100% in the normal range. If science knows so very, very much and so very, very exactly about all of these things and how they work together, then why are millions of diabetids struggling to balance insulin, activity, and food? Where’s that magic answer that so many preach? Cause I”m not seeing this in the real world.
Hi Reality check, – Type 1 diabetics can die from too low blood sugar (hypo-glycemia = 70mg/dL) & 4-10% of Type 1 diabetic deaths are a consequence of profound hypo-glycemia (< 55mg/dL = brain function impaired). Since they do not make insulin (unlike Type 2 diabetics) too high blood sugar is hard to reign in; I presume you meant to write Type 1 diabetes.
There is no "one size fits all" diet that can constantly balance the Type 1 diabetic individual's changing activities/functions to supply just the right amount of blood sugar. They risk brain seizures if run out of blood sugar & they can't over-compensate via dietary high loading their blood sugar as emergency back-up; because without insulin they risk other medical complications.
Yes, I am aware of this, only 55 mg/dl is a bit high for profound hypoglycemia in most diabetics. One can get down to a meter reading of 21 mg/dl and still be coherent and ask someone to fetch you some sweetened juice or pop. One must indeed always carry sugar in some form. It’s great you know that low blood sugars are very dangerous and the results of this. That seems to be overlooked frequently.
I know there is no “one size fits all” diet. My question was why if we know so much can we not create one? I can’t see that we know much at all about insulin, food and exercise and how they interact.
That is because there is no absolute definitive on the subject.
Medical Science is hardly exacting and while what might work for most people will not work for some in regards to intake of foods and drugs. Does this lead to researchers placing ‘can’ or ‘might’ in their comments due to the large variations of potential results?
Of the three ‘wars’ done so far this has to be the least informative of the war itself. It seems more like a bash one side of the war without dealing with how the science (or those claiming to know the science of sugar) developed into the problem of limiting our overall understanding of how sugars affect our bodies.
Prior to the current trend of beating up on sugar it was the opponents of sugar who were systematically attacked in the 60s-80s via ‘sponsored’ scientists such as Keys, or at least that is what the anti-sugar types are saying and there are plenty of documentaries produced on that aspect.
Where this differs in climate séance is that many of those who claimed an ice age was coming in the 70s then moves to globull warming in the 80s following the gravy train of activism rather than the scientific method. You generally didn’t have prevailing wind type scientists that jumped to where the government money is in this argument. Drawing parallels to Tobacco in the strategies of the respective sides and timings would indicate very high similarities.
There are also recent research still showing the negative aspect of sugar in the Dopamine reaction the body takes to elevated intake of sucrose.
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0150270
Diabetes is a more difficult question. Small studies exist, for example, of groups of indigenous people, who are in a far higher at risk group than non-indigenous groups in countries like Australia, show remission of their diabetes if they returned to their natural diet. Did they get more exercise? Was alcohol also an issue for this group etc wasn’t explained in what I had seen.
The parallel with AGW is the saturated fat ‘wars’,sugar is a minor battle.
Kip, AFAIK the first thing starches and grains do when they are eaten is turn to sugar.
I’m all in favor of eating grains – as long as they are cycled through a cow first.
As ever, the dose makes the poison. The “war on sugar” is really about EXCESS sugar consumption, much of it inadvertent because people simply don’t realise it is added to just about all processed foods, even when it isn’t necessary to make foods palatable.
I’ll stand by my comment about what I see in supermarkets.
Type 1 diabetes used to be treated by low carb (sugar is a carb), high fat, moderate protein diet which prevents spikes in blood sugar levels. Nowadaysit seems by high carb and balance with insulin. I have a friend who is Type 1 and was very careful with sugar and insulin and at age 60 is having problems. He isn’t overweight either.
Reply to Mike Borgelt ==> there are several comments from readers describing the metabolism of carbohydrates in humans. If you can’t find them, all the info you need is online.
If you believe in the paleo diet philosophy and deadly omega 6 PUFA then those there grain fed cows are a no no.
Type 1 diabetes is an auto-immune disorder and one dies without insulin. There is no low-carb diet that works because without insulin your body cannot get glucose into cells and you eventually “starve” to death while still eating normally. If you are a Type 1 making no insulin, it takes less than a week for this to happen no matter what you eat.
Yes, many foods have added sugar. One can read the label and either incorporate it into their diet or make their own foods at home. Any good diabetes educator will inform the patient of this. If they don’t, they need their certification yanked.
One person will do fine on insulin for years, another suffer complications rapidly. The newer beliefs include include a genetic component. I was told that even “tight” control cannot in any way guarantee success. It’s all individual. Telling people that “tight” control will prevent complications is incorrect—it increases the odds you won’t get the complications, but just like people with normal lipids, great eating habits and daily exercise have been known to drop dead from a heart attack, diabetics who followed all the recommendations still develop complications and some who are brittle do very well for decades.
There are days, and reading this is one of them, where I think all the advances for diabetics that measure blood sugars, including the A1c are actually very, very bad for the general public. Now anyone can measure their blood sugar and immediately jump to whatever conclusion they like concerning causes and whether or not the result is good or bad. There are studies of blood sugar in non-diaabetics but they are very small and very short. As far as I can tell, science really does not know how much people’s blood sugars fluctuate and whether or not that is good or bad. Yet there is an insistence on claiming science does and trying to dictate policy based on that non-existent knowledge. Blood sugars should never fluctuate according to much of science, but in the real world, no one knows. Those meters just gave us numbers, not many of them, and not knowledge.
Hi Reality check, – I see your correction for 21 mg/dL bood sugar level hypo-glycemia as being “profound”; so think you may be interested in following con-founders affecting home blood sugar meter readings.
* Drug (not limited to) acetaminophen, dietary ascorbic acid (& also mannitol) + balance of dopamine present issues for certain home meters. http://ajcp.oxfordjournals.org/content/113/1/75
*Humidity & excess temperature effects unused test strips may raise readings. http://tde.sagepub.com/content/26/6/981
*Meter calibration when using it may be not be done well or frequently enough. http://www.sciencedirect.com/science/article/pii/S0009898101004338
*High range blood glucose conditions can get measurement that is itself too high. http://care.diabetesjournals.org/content/21/4/585
*Low range blood glucose conditions are prone to be problematic for meter to estimate accurately. http://care.diabetesjournals.org/content/19/12/1412
*Even dirty meters &/or hands can affect readings. http://www.sciencedirect.com/science/article/pii/S0009898101004338
*Modern meters trying to make operation easier are calibrated for normal hematocrit levels, but if person has low hematocrit this alters result to read higher blood sugar. http://www.ncbi.nlm.nih.gov/pubmed/1827405
*Not using finger tip blood misses change in blood sugar. Sampling from forearm overlooks the fact that after eating a little food the blood sugar there does not go as high, nor rise as quickly, as blood glucose does in the fingers + if exercised the forearem (& leg) blood sugar will go down faster than in fingers.mpared with finger blood, forearm blood glucose appears to rise more slowly and less high after a small meal, whereas after exercise, thigh and forearm glucose levels fall lower than does fingertip glucose. So unless testing blood glucose before eating or exercising one needs to use finger blood. http://care.diabetesjournals.org/content/26/4/981
I studied sugar because I was tired of people telling me things like, Honey is good for you, but Agave is bad and High Fructose is bad, and Coke with sucrose is better for you than Coke with Hi Fructose. So I simplified figured out exactly what these things are.
Sucrose, table sugar is essentially 50% glucose 50% fructose. The glucose part immediately raises your blood sugar levels because it passes right into your blood stream and is the source of sugar the body uses as energy.
Anything higher than about 60% fructose is called high fructose sugar, usually the called corn syrup. Corn syrup is corn starch with alpha amylase, (the enzyme in your saliva that makes a saltine get sweet if you hold it in your mouth). That turns the starch into fructose and glucose.
Honey is mostly very high fructose syrup! It also has tiny amounts of maltose and ash from bee vomit.
Agave syrup is really not much different. Just no vomit.
So what’s the difference? None are good or bad.
The glucose part of the sugar can go right into your bloodstream, whereby the fructose needs the liver to process it. So high fructose raises your blood sugar slower, which has its benefits if you’re worried about blood sugar spikes.
The draw backs to high fructose are a few. Some people don’t get satiated because their blood sugar does not rise as fast, so they end up consuming more of the soda. Another not so good thing is that whatever fructose the liver cannot process turns into triglycerides!
“All of us who have studied and trained ourselves to read health studies and findings see right away the problem here. ”
Can you spell “pontificate”?
@ur momisugly Bob Johnston
July 19, 2016 at 10:18 pm
I agree heartily on Web MD. I once contacted the editor to protest about a dangerous oversimplification regarding ways of reliably neutralizing parasites in seafood, and got the bum’s rush.
I wasn’t aware of some of the information in your comment, and appreciate it, but I’ve noted some other glaring defects in the Original Post:
1. the characterization of “almost all” anti-sugar advocates as raving paranoiacs:
“In the War on Sugar, we find almost exclusively a large monolithic body of science and health researchers, ‘science popularizers’ and government agencies…[who] assert that there is a conspiracy called Big Sugar (which includes all food producers and anyone else not aligned with their view).”
2. The invocation of the BMI, one of the bluntest tools in the medical bag, and unscientific pontification “it is well established that”:
“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. ….”
(full disclosure – my own fat density measured recently at 8% by the gold standard imaging technique, and yet I have a BMI in the low 30s)
3. And the failure to clarify the most puzzling aspect of the sugar indictment – that “natural” sugars are OK, only the processed ones are a danger to human health. It’s obvious to me that brown and black bears manage to get very, very fat by gorging themselves on berry sugars in the Fall, and manage that without ever consuming processed sugars. So I would deduce that a human being consuming the same quantity of fruit would get just as fat.
And why don’t the bears suffer from diabetes and cardio-vascular disease?
As for other scientific “wars” deserving to be pacified – I would suggest the War on Radon. It is based on an unscientific assumption by the EPA, the WHO, and Health Canada, among others, that the toxicity of Radon daughters is linear, and totally ignores the concept of hormesis, well known and accepted (sometimes very belatedly) in the case of other trace elements in our environment, such a selenium.
I have not been able to get access to the original studies, but have read that experiments with lab mice in the 1950’s demonstrated that those that had all Radon removed from their food, water, and air lived only 66% as long as the control group.
It has also been reported in the mass media that people suffering from serious osteoarthritic pain reported being relieved of their pain for several months after spending a few hours in decommissioned mines having high levels of Radon. I’ve not been able to get access to any of the scientific reports on that either. But have seen video documentaries suggesting that such visits have been commercially organized and regularly scheduled in the past.