The Sour Side of Sugar

The sugar in­dus­try, like the tobacco in­dus­try, wants to hide some­thing from you. It doesn’t want you to know it’s killing you.

Santa Fe New Mexican - Healthy Living - - NEWS - BY STEPHANIE NAKHLEH

In Septem­ber 2016, The New York Times re­vealed that in the 1960s, the sugar in­dus­try paid Har­vard re­searchers the mod­ern equiv­a­lent of $50,000 to say that fat, not sugar, was the di­etary vil­lain caus­ing an uptick in chronic dis­ease. The Har­vard stud­ies paved the way for half a cen­tury of pub­lic health pol­icy that ig­nored the health risks of sugar and in­sisted that a low-fat diet was the way to pre­vent heart at­tacks and obe­sity. In 1954 sugar lob­by­ist Harry Hess said that the in­dus­try’s goal was to teach “peo­ple who had never had a course in bio­chem­istry . . . that sugar is what keeps ev­ery hu­man be­ing alive with en­ergy to face our daily prob­lems.” The lob­by­ing was ef­fec­tive. A USDA ta­ble on sugar con­sump­tion shows sugar use al­most dou­bling from 1966 — the first year on the ta­ble — to 2015.

Cor­re­lated with the rise in sugar con­sump­tion is the rise in obe­sity. The Cen­ters for Dis­ease Con­trol and Pre­ven­tion re­ports a 655 per­cent in­crease in the num­ber of Amer­i­cans di­ag­nosed with di­a­betes — al­most all of that type 2, or ac­quired, di­a­betes — since the 1950s. The obe­sity epi­demic, ac­cord­ing to the Bri­tish science jour­nal The Lancet, “is a big­ger health cri­sis glob­ally than hunger, and the lead­ing cause of dis­abil­i­ties around the world.” A paper from the Har­vard School of Pub­lic Health notes that “two out of three adults and one out of three chil­dren in the United States are over­weight or obese, and the na­tion spends an es­ti­mated $190 bil­lion a year treat­ing obe­sity-re­lated health con­di­tions.”

What’s caus­ing the ex­plo­sion in obe­sity and re­lated health prob­lems like di­a­betes and heart dis­ease? Tra­di­tional nu­tri­tion science blames such prob­lems on an “en­ergy im­bal­ance,” but oth­ers say that sugar is the cul­prit.

In his new book The Case against Sugar, science writer Gary Taubes sets out to demon­strate be­yond a doubt that sugar is a killer. Just as smok­ing turned out to be a unique cause of lung can­cer, he says, ev­i­dence is mount­ing that sugar con­sump­tion is a unique cause of di­a­betes. The “en­ergy



im­bal­ance” the­ory “ig­nores decades of med­i­cal science, in­clud­ing much of what has be­come text­book en­docrinol­ogy,” he writes in a Jan­uary 2017 ar­ti­cle for The New York Times that sum­ma­rizes the tenets of his book. “By the 1960s, re­searchers . . . had clearly demon­strated that dif­fer­ent car­bo­hy­drates, like glu­cose and fruc­tose, are me­tab­o­lized dif­fer­ently, lead­ing to dif­fer­ent hor­monal and phys­i­o­log­i­cal re­sponses, and that fat ac­cu­mu­la­tion and me­tab­o­lism were in­flu­enced pro­foundly by th­ese hor­mones.”

Dr. Mad­havi Garimella, an en­docri­nol­o­gist in Los Alamos who spe­cial­izes in di­a­betes and other meta­bolic dis­or­ders, ex­plained the process: “In­sulin is a hor­mone that is pro­duced by the pan­creas in re­sponse to el­e­vated lev­els of sugar in the blood,” she said. “In­sulin is like a key which then un­locks mus­cles and liver cells to let the blood glu­cose in. It is then used as en­ergy or stored. It also pro­motes stor­age as fat. Con­se­quently, the more sugar we eat, the more in­sulin we need to pro­duce to process it. The more weight we gain, the harder the pan­creas has to work to pro­duce more in­sulin to process the sug­ars. The body then stops re­spond­ing to in­sulin the way it should: we de­velop in­sulin re­sis­tance. The pan­creas keeps work­ing harder to over­come this, and even­tu­ally the amount of in­sulin you pro­duce is not suf­fi­cient to keep the sugar lev­els nor­mal, lead­ing to pre­di­a­betes and then di­a­betes if no di­etary mod­i­fi­ca­tion is made.”

The ev­i­dence of sugar as a unique in­sti­ga­tor of in­sulin re­sis­tance is so con­vinc­ing from a sci­en­tific and med­i­cal point of view, Garimella said, that when she sees pa­tients with di­a­betes and in­sulin re­sis­tance, she starts by ex­am­in­ing their di­ets. “I al­ways talk about diet first for di­a­betic pa­tients. Our goal is to re­duce the need for more medicine,” she said. “Ab­so­lutely no sugar is the best thing; there is no room for re­fined sugar in the diet. But if you do in­dulge, the WHO [World Health Or­ga­ni­za­tion] sug­gests get­ting 5 per­cent of calo­ries from sugar. No more.” That’s 25 grams or less per day for a 2,000-calo­rie diet. For per­spec­tive, the av­er­age Amer­i­can con­sumes 82 grams of sugar per day.

Taubes ar­gues in his book that it’s not just di­a­bet­ics and the over­weight who ben­e­fit from slash­ing sugar from their di­ets but also peo­ple prone to coronary heart dis­ease, can­cer and Alzheimer’s dis­ease. All are chronic dis­eases linked with in­flam­ma­tion, which is clearly wors­ened by a high-sugar diet. But don’t just turn to al­ter­na­tive sweet­en­ers like honey, agave syrup or ste­via for your sweet fix, Garimella warned: “We have to be aware of things that are so-called nat­u­ral but are not bet­ter. You can’t trick the gut.” The body re­sponds to nat­u­ral sug­ars such as honey and to ar­ti­fi­cial sug­ars such as su­cralose in sim­i­lar ways. It’s best, she said (and Taubes agrees), to kick the sweets en­tirely.

Be­cause the sugar in­dus­try has been so suc­cess­ful at sneak­ing its prod­uct into vir­tu­ally ev­ery­thing we con­sume, cut­ting sugar can be trick­ier than you’d think. Sweet­ened bev­er­ages like so­das and sports drinks are the pri­mary cul­prit and the first thing to cut, but con­sumers should read la­bels to find hid­den sug­ars, Taubes says. “Sugar has be­come an ingredient avoid­able in pre­pared and pack­aged foods only by con­certed and deter­mined ef­fort, ef­fec­tively ubiq­ui­tous,” he writes in his book. “Not just in ob­vi­ous sweet foods — candy bars, cook­ies, ice creams, choco­lates, so­das, juices, sports and en­ergy drinks, sweet­ened ice tea, jams and jel­lies, and break­fast ce­re­als (both cold and hot) — but also in peanut but­ter, salad dress­ing, ketchup, bar­be­cue sauces, canned soups, cold cuts, lun­cheon meats, ba­con, hot dogs, pret­zels, chips, roasted peanuts, spaghetti sauces, canned toma­toes, and breads.”

Garimella agreed. “You re­ally want to get your ‘sug­ars’ from com­plex carbs, which you can do by shop­ping the pe­riph­ery of the gro­cery store, avoid­ing food in boxes and pack­ets,” she said. “Ce­real is re­ally not a healthy food choice. Avoid su­gary drinks: prefer­ably drink wa­ter. Eat the fruit — don’t drink the juice — and be­ware of diet drinks as well.” In a de­par­ture from stan­dard nu­tri­tional or­tho­doxy, she rec­om­mends eat­ing foods that con­tain their nat­u­ral fats. “Choos­ing low-fat is not a bet­ter op­tion,” she said. “Low-fat usu­ally means more carbs, and it’s of­ten not nat­u­ral.”

The chronic dis­eases as­so­ci­ated with ex­cess sugar con­sump­tion aren’t just un­pleas­ant and ex­pen­sive: they kill. A 2015 Amer­i­can Heart As­so­ci­a­tion paper es­ti­mated the dis­ease bur­den caused by “sugar-sweet­ened bev­er­age con­sump­tion” and found that 184,000 deaths world­wide each year were as­so­ci­ated with su­gary-bev­er­age con­sump­tion. That in­cludes deaths re­lated to di­a­betes mel­li­tus (type 2), heart dis­ease and can­cer. Mean­while, the sugar in­dus­try main­tains, as an in­dus­try ad as­serted decades ago, “All foods sup­ply calo­ries and there is no dif­fer­ence be­tween the calo­ries that come from sugar or steak or grape­fruit or ice cream.” The num­bers tell a dif­fer­ent story.

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