The Case Against Sugar — New Book Reveals the Details of How the World Got Addicted to Sugar

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Story at-a-glance –
• Evidence suggests excess sugar is a foundational cause of diabetes, obesity and most chronic degenerative diseases, including Alzheimer’s and Parkinson’s, not just an exacerbating factor
• There are significant similarities between the sugar industry and the tobacco industry, with the same kind of flawed science used to defend tobacco now being applied to sugar
• Like other addictive substances, sugar triggers dopamine secretions in the reward center in your brain.
By Dr. Mercola
Few would argue that excess refined sugar is pernicious to our health. However, hardly anyone is aware of the manipulation and deceit initiated and perpetuated by the sugar industry to insulate us from this truth.
Gary Taubes, an investigative journalist with a strong science background, has written an excellent book, “The Case Against Sugar,” which expertly documents how the manipulation of facts occurred.
“Beginning in the early ’90s, I started reporting on public health and, indeed, a lot of the rigorous methodology that I have been told was absolutely fundamentally necessary to get a reliable result was considered sort of a luxury that you didn’t have to do in public health research.
It’s too hard. It’s too expensive, so you don’t have to do it. As a result … a lot of the fundamental tenets — our belief system about what constitutes a healthy diet — is based on very shaky evidence,” Taubes says.
By the late ’90s, Taubes was investigating the ideas that salt causes high blood pressure and dietary fat causes heart disease, which resulted in a pair of award-winning reports for the Journal of Science. In 2001, he published The New York Times Magazine cover story, “What If It’s All Been a Big Fat Lie?”
In the years since, Taubes has been wholly focused on nutrition research, which resulted in three books. The two preceding “The Case Against Sugar” were “Good Calories, Bad Calories: Fats, Carbs, and the Controversial Science of Diet and Health,” and “Why We Get Fat: And What to Do About It.”
“Now I’m just focusing in on sugar and why we probably should consider it the primary evil in our diets,” he says.
Taubes was also kind enough to be one of the two dozen professional reviewers for my new book “Fat for Fuel” that comes out in May, and I deeply appreciate the many helpful and thoughtful edits and suggestions he provided.
The Early Slave Trade
In his book, Taubes makes a strong argument that excess sugar is the foundational cause of diabetes, obesity and most chronic degenerative diseases, including Alzheimer’s and Parkinson’s.
He also notes the incredible similarities between the sugar industry and the tobacco industry. It’s déjà vu all over again, with the same type of flawed science used to defend tobacco now being applied to sugar. He also reveals the historical background that led to sugar becoming a dietary staple, opposed to a rare treat.
“One of the things we tend to forget [is] that sugar was 1 of 3 or 4 different sort of drugs, for lack of a better word, that came out of the tropics with the colonization of the Americas … and then changed the world.
Sugar, caffeine, nicotine, alcohol and to some extent various drugs like opium … were the trade on which empires were built. Sugar was particularly unique because cultivating sugar is an unbelievably arduous, painful, difficult job.
As such, you couldn’t really pay anyone enough to do it … Instead … they started using slaves to cultivate sugar. When we started cultivating sugar in the Americas … they imported slaves to the Tulum … 12 million slaves lived and died working in the sugar fields.”
Sugar Taxation Was a Financial Boon for Government
By 1830, the emancipation movement beginning in the United Kingdom had finally put an end to the slave trade, although the use of slaves in the U.S. didn’t end until the 1860s. The use of slaves shaped our culture, and the sugar industry helped drive the creation of that slave trade in the first place.
As noted by Taubes, people were willing to enslave millions for the purpose of growing and shipping sugar. The very heart of commerce in the 19th century was the sugar trade. The British and American governments also got in on the action when they realized it was a perfect item for taxation.
“In a sense, our governments themselves got addicted to the money that could be made by allowing sugar to flow into the nation.
This continued in the U.K. to the late 19th century when the sugar trade or sugar tax was finally shut down. But in the U.S., we never stopped the sugar tax, because it was simply too valuable,” Taubes says.
Sugar in the 21st Century
All through the 19th century, there were many people warning that sugar is bad for health. A lot of physicians noted increases in illness and depression among people who were eating more sugar. However, no one really understood or was able to quantify the risks.
In the 1920s, sugar consumption was linked to a rise in diabetes. Today, many view sugar as a factor that worsens diabetes, but Taubes suggests sugar is in fact the very root of the problem, not just an exacerbating factor after the fact.
“One story I tell in the beginning of the book is of Elliott Joslin, who became the most famous diabetes doctor in the 20th century in the U.S. and around the world. Joslin saw his first diabetes case when he was in medical school at Harvard Medical School in the 1890s.
Then, in 1898 (with another physician named Reginald Fitz, a pathologist at Harvard), he goes through hundreds of volumes of handwritten records of the Massachusetts General Hospital … He looks at the patient records of every single patient at this hospital from 1824 to 1898, 48,000 records.
He comes up with 172 cases of diabetes total. In fact, from 1824 to 1850, most years there were zero cases of diabetes … [It] was an excruciatingly rare disease. One influential British physician estimated that 1 in 50,000 individuals in the U.K. had diabetes.
William Osler, the father of modern medicine in the U.S. who was practicing at Johns Hopkins, took the in-patient records from Johns Hopkins hospital in Baltimore from its opening year in 1889 to 1892 and found 10 cases out of something like 35,000 patients. Today, we’re talking about a disease that afflicts 1 in 11 Americans.”
Worse, the pre-diabetic population in the U.S. is rapidly approaching 1 in 3, and insulin resistance and diabetes are at epidemic levels across the world. Clearly, something dramatic has happened to increase prevalence so drastically.
According to Taubes, that change is the access and availability of refined sugar and, later, the addition of high-fructose corn syrup.
Sugar Science
Taubes casts as much blame for what happened next on the scientific and medical community as on the sugar industry itself. They simply didn’t understand how to conduct good nutritional science. In a recent Los Angeles Times op-ed,1 investigative journalist Nina Teicholz also makes a case saying the sugar industry doesn’t necessarily deserve being scapegoated since a lot of different food producers profited handsomely from the demonization of dietary fat, especially the grain and vegetable oil industries.
But just how did everyone miss the fact that sugar causes diabetes? As Taubes explains, a vast majority of diabetes cases are associated with obesity, so physicians and nutritionists simply deduced that obesity must be the cause. And, since obesity was (incorrectly) thought to be caused by eating too much and exercising too little (the energy balance theory), the role of sugar in diabetes remained unrecognized.
Moreover, since it was assumed that all calories are created equal, sugar was not considered to be any different from any other carbohydrate. Today we know this simply isn’t true.
“In the book, I referred to [this thinking] as the gift that keeps on giving. Because once the obesity research decided that obesity is caused by merely taking in more energy than we expend, and therefore all calories are equivalent, then that became the defense of the sugar industry.
Beginning in the 1920s, the sugar industry formed The Sugar Association. They put advertisements in newspapers, pushing sugar consumption when physicians in research were really beginning to get suspicious about sugar and diabetes. They said, ‘Look, it’s not fattening. It’s low-calorie. A teaspoon of sugar is only 16 calories. Five teaspoons have fewer calories than an apple. Therefore, enjoy your sugar. It’s all about calories.’
They advertised it based on this very substandard science at the time, [showing it] being beneficial, giving you more energy (which it does do in the short term), being good for colds and your immune system in the winter, and being good to cool you down with lemonade in the summer … They took the bad science … [suggesting] obesity is just an energy balance issue, and they ran with it …
[L]ast year, The New York Times reported that Coca-Cola had funded something called The Global Energy Balance Network. This was researchers who were going to point out that you don’t get fat or get diabetic because of how much Coke you drink; you get fatter and diabetic when you’re consuming more calories than you expend. Therefore, you should expend more and exercise …
Once The New York Times pointed it out, Coca-Cola immediately realized that this was a bad public relations move and pulled back. The universities gave back the funding. But they’re still trying [to say that] it’s not about Coke, it’s about too many calories.”
Wartime Sugar
As World War II started, the U.S. government realized sugar would have to be rationed since a lot of the sugar trade would be lost. To soften the blow, they started warning Americans about the dangers of sugar to their health, using that as a way to put a positive spin on the situation. The sugar industry, on the other hand, became quite nervous over this. They didn’t want people’s sugar consumption habits to change or be radically altered.
They had to come up with a way to make sure people would resume eating as much sugar as possible after the war. To that aim, The Sugar Association began funding research in 1942, to demonstrate that sugar is actually good for you, and also to look for novel uses of sugar. Fred Stare and Ancel Keys were two prominent researchers funded by The Sugar Association.
Stare, who ran the nutrition department at Harvard, considered it part of his job to raise money from industry. He proudly discussed this in his memoir. He raised millions from the sugar industry and the cereal industry, and whatever they needed, he provided, whether it was Congressional testimony or discussing the benefits of sugar on radio or TV.
“This was later exposed [in] 1977 by Mike Jacobson of the Center for Science in the Public Interest. But for nearly 20 years, Fred Stare and the Harvard Nutrition Department, funded in part by the sugar industry, pushed this belief that fat was the problem and sugar was harmless,” Taubes says.
“In the ’80s, [sugar consumption] starts to skyrocket again — in part because of the success of this idea that fat is the problem … The iconic example of that is yogurt, where you take some of the fat out and you add high-fructose corn syrup to replace the mouth feel and the taste, and you end up with this fruity sugary yogurt that nobody knows is bad for you and can be pitched as a health food because it’s low in fat …
You’ve got all these juices exploding: Snapple, SoBe iced teas, where all the calories are coming from high-fructose corn syrup but people don’t realize it’s sugar. This continues through the late ’90s when suddenly we become aware, based on a couple CDC reports, that there’s an obesity epidemic. That first report in 1995 gets a lot of press …
Suddenly, in 1999, sugar consumption peaks … Part of what happened, I think, is that we became aware that high-fructose corn syrup is also sugar. Although, when I first started reporting this in the early 2000s, even most researchers didn’t understand that.
I talked to epidemiologists at Harvard, gastroenterologists, people who were studying either fructose or high-fructose corn syrup or sugar, and they didn’t understand that they were all roughly 50:50 combinations of the two [glucose and fructose].”
Surprising Links Between Sugar and Tobacco
Taubes also describes how sugar and tobacco are linked — a synergy that is not entirely intuitive. Sure, the same science strategies that the tobacco industry used to support their product was also copied by the sugar industry to support the consumption of sugar. But that’s not the only link between these two industries.
Interestingly, Taubes claims that sugar has likely killed more people than tobacco, and that tobacco wouldn’t have killed as many people as it did without sugar. This is a fascinating story in and of itself, which Taubes details in greater depth in his book.
In summary, the big revolution in tobacco processing in the 19th century was something called “flue-curing tobacco.” It’s been referred to as one of the deadliest inventions in the history of mankind; worse than guns and nuclear weapons in terms of how many people it has killed.
The process involves drying the tobacco leaves over heated iron plates. Aside from drying the leaves, this process also increases the sugar content in the leaves. Tobacco leaves, which start out with about 3 percent sugar end up with about 22 percent sugar after the flue-curing is complete.
Flue-curing is done to make the tobacco easier to smoke. The higher the sugar content in the leaves, the more acidic the smoke and the easier it is to inhale without irritation and coughing. In other words, it creates a “smoother” smoke. Flue-cured tobacco allowed cigarettes to be inhalable in a way that pipe tobacco or cigar tobacco wasn’t.
The Birth of Camel
Up until 1913, American cigarettes were made from flue-cured Virginia tobacco, which also had a very low nicotine content and therefore was not particularly addictive. At that point, R.J. Reynolds decided to blend the burley tobacco (a chewing tobacco known as Burley Plug tobacco) with flue-cured Virginia tobacco.
“The thing about this chewing tobacco is that it was marinated. This was another invention in the 19th century. This is what they called sugar sauce. You basically take these leaves which can soak up 50 percent of their weight in sugar. You marinate them in sugar, maple syrup, licorice, spices and you get the wonderful taste of chewing tobacco.
By doing so, you make the burley tobacco inhalable. It gives it a wonderful aromatic taste, and the burley tobacco has a high nicotine content. That nicotine is very available,” Taubes explains.
The first blended cigarette ever made, Camel, was produced in 1913. It was easy to inhale and contained large amounts of nicotine, thanks to the inclusion of the burley tobacco. It also contained copious amounts of carcinogens. Camel exploded in popularity, and by the 1920s, it was the most popular cigarette brand in America. By the 1930s, virtually every cigarette in America contained a blend of, mostly, burley and flue-cured Virginia tobacco.
With Blended, High-Sugar Smokes Came Rising Lung Cancer Rates
Prior to Camel, lung cancer was virtually non-existent. In subsequent decades, lung cancer rates exploded — and it all goes back to the elevated sugar content of the flue-cured tobacco leaf. More recently, researchers have also shown that the use of phosphate fertilizers may be a contributing factor. Phosphate fertilizers are actually contaminated with radioactive polonium, which contaminates the plant and is inhaled when you smoke the leaves.
“Again, one of the messages that I took away from this is, first, understanding the relationship between diet, the environment and our health is an excruciatingly difficult job. Something I repeat several times in the book is that we’re trying to understand the cause of chronic disease that takes decades to manifest …
The science is really hard and as a result, a good working assumption is to take everything with a grain of salt. But you have to establish certain inherent belief systems. A good one is that if we didn’t eat it 2,000 years ago, we might not want to eat it today,” Taubes says.
“I think the sugar industry — as they point out that the evidence is not unambiguous — it’s incumbent upon them to point out what research should be done to resolve this issue. It’s not enough to say, ‘My client is innocent because there’s not enough evidence to convict them.’ The point is there’s plenty of evidence. What would it take to settle this issue? You could do that with research, randomized controlled trials …
You’ve got this one issue, which is: What is the environmental trigger of the disease? I think it’s sugar. Add sugar to any population — Southeast Asians were already consuming a lot of rice and wheat and had a low-fat diet, but were relatively healthy until they started consuming sugar in quantities.
The Inuit are consuming almost exclusively animal products from marine animals and fish and caribou. We add sugar, boom, you get the same diseases. That’s the issue this book is addressing.”
How Little Sugar Is Still Too Much?
It’s tempting to say that eating sugar “in moderation” is the answer. But how much is a moderate amount? As noted by Taubes, moderation is defined as “the amount you can eat and not be fat or diabetic.” But for some that could be as low as zero if they’re genetically predisposed to obesity. On a societal level, right around 70 pounds of sugar per capita per year is where populations start experiencing epidemics of diabetes.
Theoretically, it’s possible that staying below that, at say 25 or 40 pounds per year, would allow you to remain healthy. However, when sugar is so readily available everywhere, will you really be able to stay below a certain level? Or would it be easier to just quit sugar altogether? As with smoking, sugar has an addictive quality, and consumption can easily get out of hand when you’re eating a lot of processed foods.
“Some people can clearly deal with moderate amounts of sugar, and other people can’t,” Taubes says. “I find it much easier to not eat any at all than to try and eat it in moderation. My wife can order a wonderful dessert in an expensive restaurant, take two bites, push it away. That’s the end of it. I am not her.”
Taubes discusses the addiction potential of sugar in his book, explaining how sugar affects the reward center in your brain, the nucleus accumbens. Sugar, like other addictive substances and behaviors, trigger dopamine secretions.
“There’s a French researcher who was studying sugar addiction in rodents, and found that you could addict a rat to cocaine or heroin, [then] offer it sugar instead of cocaine or heroin and it would switch to the sugar within a day. If it could only get sugar or cocaine, it would continue to prefer sugar over cocaine from then on. Again, there’s reason to believe that this is a highly addictive substance. But it’s also clearly addictive differently than these other substances,” Taubes says.


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