The Case Against Sugar

by Gary Taubes

Nutrition hypotheses are particularly challenging because they’re often about how foods or constituents of foods or dietary patterns influence our pursuit of a long and healthy life. The hypothesis addressed in this book, for instance, is that sugar is the dietary trigger of obesity and diabetes and, if so, the diseases such as heart disease that associate with them. But this hypothesis is ultimately about what happens to us over decades—the time it takes chronic diseases to manifest themselves—and not months, as is the case, say, with vitamin-deficiency diseases like scurvy or beriberi.

The trial, known as the Women’s Health Initiative, was launched in the early 1990s, and the results were reported in 2006. Once again, it failed to confirm the hypothesis. The roughly twenty thousand women in the trial who had been counseled to consume low-fat diets (and to eat more fruits, vegetables, and whole grains, and less red meat) saw no health benefits compared with the women who had been given no dietary instructions whatsoever.

If you look through nearly all nutritional advice the only thing that seems to tie them together is that we should all be eating more vegetables.

A more nuanced perspective, one nourished by scientific progress, would be that if two foods or macronutrients are metabolized differently—if glucose and fructose, for instance, are metabolized in entirely different organs, as they mostly are—then they are likely to have vastly different effects on the hormones and enzymes that control or regulate the storage of fat in fat cells.

Interesting. What research has been done comparing metabolism of different types of sugars?

They had come to believe that fat was bad for the heart and that too much protein could put an unhealthy strain on the kidneys. Now Reaven was bringing back the notion that carbohydrates were bad. “We have to eat something,” the NIH official said, but what would be left?

Vegetables. Break out the kale chips.

When populations underwent Westernization, chronic diseases emerged with it, whether rapid or not, and typically in the same order, beginning with periodontal disease (tooth decay), gout, obesity, diabetes, and hypertension, and eventually encompassing all of them.

In Burkitt and Trowell’s provisional list of diseases caused by exposure to a Western lifestyle, conditions such as appendicitis and tooth decay appeared typically in childhood.

I had appendicitis at about the age of 2. Not sure what this implies for my future health.

As it turns out, a nearly vegetarian diet is likely to have only a very modest effect on uric acid levels—at least compared with a typical American diet—rarely sufficient to return high uric acid levels to normality, and there’s little evidence that such diets reliably reduce the incidence of gouty attacks in those afflicted.

Second, no population seemed to be exempt from cancer, but it was still undeniably rare in aboriginal or indigenous populations—in “the savage races,” as the report put it.

Reading through historical documents requires looking past the racism to see the facts.

As the University of California, Berkeley, authority Michael Pollan has so memorably put it, we should “eat food. Not too much. Mostly plants.” If we do this, we will get as close as we reasonably can to a healthy diet.

Trying to consume sugar in moderation, however it’s defined, in such a world is likely to be no more successful for some of us than trying to smoke cigarettes in moderation—just a few cigarettes a day, rather than a pack.

Then there was Thomas Willis in the 1670s, the first physician in Europe to note the sweet taste and smell of diabetic urine, despite a long tradition among European physicians at the time of tasting urine as a diagnostic technique.

Former cigarette smokers (of which I am one) will tell you that it was impossible for them to grasp intellectually or emotionally what life would be like without cigarettes until they quit; that through weeks or months or even years, it was a constant struggle. Then, one day, they reached a point at which they couldn’t imagine smoking a cigarette and couldn’t imagine why they had ever smoked, let alone found it desirable. A similar experience is likely to be true of sugar—but until we try to live without it, until we try to sustain that effort for more than days, or just a few weeks, we’ll never know.

My takeaway from this whole book is that I should do a 30 day challenge to avoid sugar. I expect it will be difficult and my chance of failure is high, but if the arguments from this book are to believed it would be a worthwhile endeavor on a path to lower my lifetime consumption of sugar.