🌻Is Sugar Really That Bad?

The sugar industry calls baloney on the latest science suggesting spoonful limits. Here’s the reality of the risks.

Knowing what to eat is really hard, given all the changing and conflicting advice. But this much is as predictable as a child’s distaste for broccoli: Whenever new evidence suggests something we love is bad for us, you can bet some industry group will call the research baloney. So here we go again.

A large review of research published recently in the journal BMJ linked added sugar to 45 different adverse health outcomes, conditions that often simmer for years before symptoms suddenly boil to the surface, including obesity, diabetes, heart disease, depression, some cancers, and the big one: death. The researchers recommend limiting consumption of added sugars to six teaspoons daily, and constricting sugar-sweetened drinks to one a week — suggestions that are in line with guidelines set long ago by the World Health Organization.

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For context…

The average American consumes about 17 teaspoons of added sugar daily — some 57 pounds per year. Most is from sweetened drinks, cereal, desserts, snacks and other highly processed food, but also seemingly healthy stuff like flavored yogurt or a range of surprisingly sweetened alternative milks.

I love an afternoon donut now and then. Cave to the craving for ice cream a little too often. Frequently enjoy a square or two of dark chocolate. So I won’t get all preachy about banishing sugar. No, this story is about moderation versus excess, science versus industry marketing, healthy eating versus known risks we can choose to lean into or away from.

Questions of quality

The new study was a review of reviews, slicing and dicing results from 73 previous meta-analyses that had, in turn, analyzed 8,601 scientific publications. Such umbrella reviews, though not guaranteed to produce a convincing stew of conclusions, are a recipe researchers use to glean further insight from existing research, like taking a 30,000-foot assessment of what’s out there rather than a myopic view of a handful of studies or a single outlier, with an emphasis on sifting wheat from chaff.

The researchers evaluated the quality of the various studies under review from high to low as a way to season their determinations. Much of the evidence was deemed of low to moderate quality. Among their strongest conclusions, based on the research deemed most reliable (though not perfect):

“Significant harmful associations were found between dietary sugar consumption and 18 endocrine or metabolic outcomes including diabetes, gout and obesity; 10 cardiovascular outcomes including high blood pressure, heart attack and stroke; seven cancer outcomes including breast, prostate and pancreatic cancer; and 10 other outcomes including asthma, tooth decay, depression and death.”

Courtney Gaine, president and CEO of the Sugar Association, took issue with several aspects of the study.

“This is a review of existing evidence, and even a well-executed systematic review is only as good as the studies that are inputted,” Gaine told the website FoodNavigator-USA. “Essentially, garbage in equals garbage out, and it is known that added sugars literature suffers from significant variability when it comes to definitions, intake measurements and control of energy and other diet and lifestyle variables.”

Sugar may be likened to nutritional trash, but the research going into the new study is not exactly a heap of garbage.

Sure, no single study proves cause and effect, and studies often have wildly different methodologies and results. That’s actually the beauty of science, the basis for increased understanding and consensus. Scientists love to prove each other wrong, so they try, and try, and try. When the preponderance of evidence points notably in one direction, as it does with the negative health effects of added sugar, then even sans any idealistic “proof,” a sensible person can glean some helpful assumptions and conclusions.

Marion Nestle, PhD, author and emeritus professor of nutrition and public health at New York University, is a sensible person steeped in this sort of research. She had this to say about the new study and the industry reaction:

“The authors admit the evidence is not strong,” Nestle writes in her daily newsletter. “But there’s just so much of it, and it’s not going away. When it comes to sugars, less is better, alas.”

Another vote against sugar came today from a group of 10 researchers, nutritionists and doctors who rated 10 popular diets and eating patterns for their effects on heart health. DASH and Mediterranean dietary patterns topped the list, followed by vegetarian then vegan diets. At the bottom: paleo and keto. No surprises there, but the experts stressed one important tidbit, the only suggestion that accompanied all 10 diet patterns:

“Minimize the intake of foods and beverages with added sugars.”

The huge, hidden, real problem with sugar

Most people don’t sit around sucking down teaspoons of sugar. So what’s the real problem here?

Added sugar may or may not be, by itself, the ultimate evil in our diets, though it’s certainly a strong podium candidate. Added sugar, to be clear, is a preference, not a need. We can get all the sugar our bodies need from fruits, vegetables and the digestion of other carbohydrates, which the body processes slowly enough to keep us fueled up for long periods. Added sugars get absorbed into the body too quickly, overloading the digestive system and ultimately causing a crash in blood glucose levelsthat fuels an unhealthy cycle of hunger.

Regardless of any direct ill effects, added sugar is a clear proxy for the bigger problem behind modern Western society’s poor health: highly processed food.

More than half of all calories consumed in the United States and the U.K. come from highly processed food. And I use the word “food” liberally.

All this junk food and non-food is loaded up with sugar, salt, and a bewildering multitude of multisyllabic unmentionables and unpronounceables. You may not even see “sugar” on the label. Added sugar can be cloaked by about two dozen names, including corn syrup, maple syrup, honey, dextrose, fructose, glucose, sucrose, maltose and molasses.

The combination of crap packed into processed foods is decidedly deadly and alarmingly addictive, recent research found.

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Meanwhile, obesity rates have skyrocketed in recent decades, among adults and among children, and obesity is a prime risk factor for type 2 diabetes, heart disease and other chronic ailments. Sedentary lifestyles are one of many factors deserving blame, but highly processed foods, including sugar-laden meals and snacks and drinks, are prime culprits.

To think excessive sugar intake isn’t part of our society-wide health problems is to stick your head and your entire gastrointestinal tract in a huge hole in the sands of health denial.

Yeah, but I buy sugar-free stuff!

You might be thinking: Just switch to artificial sweeteners. Not a bad idea, in concept. Problem is, the food industry is way ahead of you.

All that highly processed food we’ve become so addicted to now comes in “sugar-free” variations, suggesting there’s health and well-being packed into the box or bag or can. There is not.

While zero-calorie sugar substitutes may, when consumed in moderation, be better for you than sugar, there is emerging evidence linking some of them to higher risk for cancer, cardiovascular disease and other conditions. A lot more research is needed on sugar substitutes, but the real problem with them is what they’re baked into — junk food and drinks — and how they’re marketed.

“Most foods that have these sugar subs are not healthy to begin with, and replacing the sugar gives the food a ‘health halo’ in a sense where we may feel the food is healthier because it has ‘zero added sugar,'” Liz Weinandy, RDN, an instructor of practice in medical dietetics at Ohio State University’s Wexner Medical Center, told me recently.

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No matter what the sugar industry advocacy group says, no matter what enticements manufacturers put on packaged food products, the bottom line is abundantly clear: If you want to lower your risk of chronic health conditions and up your odds of a long, healthy life, avoiding products loaded with added sugar, or cutting back, is a smart start.

If you want to stick a fork in the food industry’s insidious ploy to sell you junk you wouldn’t feed a dog, read labels. Better yet–if you’re fortunate enough to have access to a decent grocery story, and not everyone is–aim to buy a variety of foods that have no labels. Hard to go wrong with single-ingredient foods.

Contributed by Robert Roy Britt

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