The Case Against Sugar

by Gary Taubes

As many diabetics were admitted to Mass General in the thirteen years after 1885 as in the sixty-one years prior.

The beginning of an epidemic

A dozen classes of drugs are now available to treat the disease, and the market for diabetic drugs and devices in the United States alone is over thirty billion dollars yearly.

In fact, anywhere populations begin eating Western diets and living Western lifestyles—whenever and wherever they’re acculturated or urbanized, as West noted in 1978—diabetes epidemics follow.

And on those very rare occasions when sugar consumption declined—as it did, for instance, during World War I, because of government rationing and sugar shortages—diabetes mortality invariably declined with it.

By the late 1970s, though, sugar had mostly vanished from the discussion. Dietary fat had been implicated as a cause of heart disease. Nutritionists and public-health authorities responded by rejecting the idea that sugar could be responsible for the diseases that associated with heart disease, which included both obesity and diabetes.

sugars like sucrose and high-fructose corn syrup are fundamental causes of diabetes and obesity, using the same simple concept of causality that we employ when we say smoking cigarettes causes lung cancer.

Those who are obese and diabetic also tend to be hypertensive; they have a higher risk of heart disease, cancer, and stroke, and possibly dementia and even Alzheimer’s disease as well.

A conservative estimate is that they cost the medical system and our society, in lost work and productivity, one trillion dollars a year.

procure, although there may be natural limits set by culture and current attitudes about food. The primary barrier to more consumption—up to the point where populations become obese and diabetic and then, perhaps, beyond—has tended to be availability and price.

If this can be proven, taxes or size limits do not seem unrealistic

sugar is one of a handful of “drug foods,” to use Mintz’s term, that came out of the tropics, and on which European empires were built from the sixteenth century onward, the others being, tea, coffee, chocolate, rum, and tobacco.

John Pemberton, the inventor of Coca-Cola, had a morphine addiction that he’d acquired after being wounded in the Civil War. Coca-Cola was one of several patent medicines he invented to help wean him off the harder drug.

As for tobacco, sugar was, and still is, a critical ingredient in the American blended-tobacco cigarette, the first of which was Camel, introduced by R. J. Reynolds in 1913. It’s this “marriage of tobacco and sugar,” as a sugar-industry report described it in 1950, that makes for the “mild” experience of smoking cigarettes as compared with cigars

“Taken together, the new drugs gave English society an almighty hit; the Empire, it might be said, was built on a huge sugar, caffeine and nicotine rush—a rush nearly everyone could experience.”

Sugar, more than anything, seems to have made life worth living (as it still does) for so many, particularly those whose lives were absent the kind of pleasures that relative wealth and daily hours of leisure might otherwise provide.

Link to obesity map

Sugar does induce the same responses in the region of the brain known as the “reward center”—technically, the nucleus accumbens—as do nicotine, cocaine, heroin, and alcohol.

the per capita consumption of candy in the United States doubled with the beginning of Prohibition in 1919, as Americans apparently turned en masse from alcohol to sweets. Ice-cream consumption showed a “tremendous increase” coincident with Prohibition.

The barriers to the increased consumption of sugar, as I suggested earlier, would invariably be cost and availability, which in turn were constrained by land and labor.

From the seventeenth through the nineteenth centuries, sugar was the equivalent, economically and politically, of oil in the twentieth.

England in 1874, when the government finally abolished import duties, on the basis that sugar had become, as one member of Parliament described it, “the delight of childhood and the solace of old age,” besides being “exceedingly nutritious and wholesome”;

Sugar as an entitlement

When the U.S. Department of Agriculture was founded in 1862, its impetus, as much as anything, was to encourage sugar-beet production.

By the 1920s, sugar refineries were producing as much sugar in a single day—millions of pounds—as would have taken refineries in the 1820s an entire decade.

the concept of a dessert course emerged for the first time in history in the mid-nineteenth century, the expectation of a serving of sweets to finish off a lunch or dinner.

A remarkable proportion of the chocolate staples of the twentieth century and today were first created and mass-produced between 1886 (the Clark bar) and the early 1930s—Tootsie Rolls (1896), Hershey’s Milk Chocolate bar (1900), Hershey’s Kisses (1906), Toblerone (1908), the Heath bar (1914), Oh Henry! (1920), Baby Ruth (1921), Mounds and Milky Way (1923), Mr. Goodbar (1925), Milk Duds (1926), Reese’s Peanut Butter Cups (1928), Snickers (1930), Tootsie Roll Pops (1931), and the Mars and 3 Musketeers bars (1932).

Among the several existing creation myths, one that is taken seriously is that Ernest Hamwi, a waffle maker, had a concession stand at the fair next to an ice-cream dealer who ran out of cups in which to sell his ice cream. Hamwi rolled his waffles into cones, the ice cream was added, and the rest is history.

Such an investigation is pertinent not only because the cigarette consumption has reached an all-time high in the United States, but the American blended cigarette, this product of the marriage of tobacco and sugar, is now rapidly gaining popularity all over the world.

Only 150 cases of lung cancer were diagnosed in the United States in total prior to 1900.

“In hard times [consumers] will give up a lot of necessities,” he said, “but the last thing they will give up is their vices.”

“The peculiar evil is this,” he wrote. “A millionaire may enjoy breakfasting off orange juice and Ryvita biscuits; an unemployed man doesn’t….When you are unemployed, which is to say when you are underfed, harassed, bored and miserable, you don’t want to eat dull wholesome food. You want something a little bit ‘tasty.’ There is always some cheaply pleasant thing to tempt you.”

Annual per capita sugar consumption in the depth of the Great Depression was sixteen pounds higher than it had been in 1920.

Many consumers had become accustomed to drinking fruit juices instead of alcohol during the Depression.

Still, in an era when malnutrition and undernutrition were pervasive problems throughout Europe, sugar’s ability to put fat on the lean or emaciated was widely perceived as one of its beneficial qualities.

“taken in tea, milk, and beer, [sugar] has caused lean people to grow fat, and has increased the vigour of their bodies.”

The legendary British climber George Mallory said that in his 1923 attempt on Mount Everest, he succeeded in making it within two thousand feet of the summit by living on sugar for the last few days of the ascent: almost exclusively lemon drops, peppermint candies, and chocolate.

Sugar as a PED

“At great elevations no one has any strength to waste on unnecessary processes of digestion,” Mallory said; “sugar…can be digested quickly and easily converted into muscular energy. It has also a much-needed stimulating effect.”

The Japanese experience could have been used to support the sugar/diabetes connection just as Joslin and Himsworth used it to refute the connection.

Common cognitive error. Interesting anecdote for any proof. Ask yourself of any proof, are variables sufficiently isolated? Is this observation proving what I think it proves?

As the German and Austrian medical-research communities evaporated with the rise of Hitler and the devastation of the Second World War, the notion of obesity as a hormonal regulatory disorder effectively evaporated with it. The primary German textbook on endocrinology and internal medicine in the 1950s still included a discussion of this thinking, but that textbook never saw an English translation, which is significant, since the lingua franca of medical science had now shifted from German prewar to English afterward. The German-language journals from the prewar era, and with them the best scientific thinking of the era in all the disciplines relevant to both obesity and diabetes—including metabolism, endocrinology, nutrition, and genetics—would no longer be read, nor would they be referenced.

Roosevelt’s perspective on sugar and saccharin, however, was different. He was fat and in danger of getting fatter, and his personal physician, or so Roosevelt told Wiley, had counseled him to use saccharin daily. Hence, “anybody who says saccharin is injurious is an idiot.” That was the end of the argument.

Between 1963 and 1969, the Sugar Association spent more than two-thirds of a million dollars (over four million today) on research designed to force the FDA to remove cyclamates from the GRAS list and have them banned.

Two years later, when John Hickson left the International Sugar Research Foundation to work for the Cigar Research Council, he was described in a confidential tobacco-industry memo as a “supreme scientific politician who had been successful in condemning cyclamates, on behalf of the Sugar Research [Foundation], on somewhat shaky evidence which he had been able to conjure out of Wisconsin Alumni Research Foundation.”

The “enemies of sugar,”

These enemies were the “persuasive purveyors of nutritional rubbish,” said Tatem, the “opportunists dedicated to exploiting the consuming public,” “the promoters and quacks” who “calculatedly enlist the mass media to their ends,” who “neatly apply Goebbels’ ‘Big Lie’ technique,” and who had “successfully misled a great many well-meaning advocates and media commentators.” As a result of this campaign of anti-sugar propaganda, said Tatem, “sugar, once accepted almost without question, has become a highly controversial food.” And if we wanted to learn the truth, we’d have to “wade through yards of pseudoscientific drivel” to do it.

Mayer had published an article in June 1976 in The New York Times Magazine—“The Bitter Truth About Sugar”—linking sugar not just to cavities and tooth decay but to obesity and type 2 diabetes,

By the mid-1980s, academic or government researchers who suggested that sugar could be a cause of heart disease or diabetes said they were risking their credibility in the process. Largely because of the sugar industry’s public-relations triumph,

University of Minnesota nutritionist Ancel Keys was arguing that high blood levels of cholesterol caused heart disease, and that it was the fat in our diets that drove up cholesterol levels. Keys had a conflict of interest: his research had been funded by the sugar industry—the Sugar Research Foundation and then the Sugar Association—since 1944,

Fat consumption may have increased in the United States since the early twentieth century, according to USDA statistics, but the reported increase was not nearly as dramatic or as certain as it had been for sugar since the 1850s.

“We now eat in two weeks the amount of sugar our ancestors of 200 years ago ate in a whole year,”

the refining of sugar and white flour and the dramatic increase in their consumption since the mid-nineteenth century were the most significant changes in human nutrition since the introduction of agriculture roughly ten thousand years before.

“diseases of civilization” to describe the cluster of diseases including obesity, diabetes, and heart disease that are common in affluent Western societies and uncommon elsewhere.

“In the three years after Stare told a Congressional hearing on the nutritional value of cereals that ‘breakfast cereals are good foods,’ ” Jacobson and his colleagues wrote, “the Harvard School of Public Health received about $200,000 from Kellogg, Nabisco, and their related corporate foundations.”

Whether we consider this right or wrong, ethical or unethical, the committee’s review of sugar relied heavily on the Sugar Association’s “Sugar in the Diet of Man” and its authors.