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What's so bad about sugar?

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Case-Against-Sugar.jpg What's so bad about sugar? According to this week's EconTalk guest Gary Taubes, just about everything. Taubes's real concern is insulin resistance, which he argues is the trigger for most diseases that afflict the denizens of the Western world. While we don't really know just how much sugar the average person consumes, the FDA estimates sugar consumption has seen a thirty-fold increase- from approximately five pounds per capita annually to approximately 155 pounds- in the last 200 years. Taubes speculates on whether sugar is better considered a drug or a food (prompting some hilarious confessions and a Willy Wonka reference from host Russ Roberts), and poses a very interesting thought experiment. (This starts at about the twelve minute mark; give it a try... I did, and it was a little scary...)

Taubes reminds listeners that his new book and the subject of this conversation, The Case Against Sugar, is like all his previous work; it's really about good science versus bad science. Because the human body, like the economy, is so very complex, it's extremely difficult to parse out the effect of a single variable. Taubes maintains though, that every culture which adopts the Western diet and lifestyle invariably falls victim to the cocktail of ailments we face- including obesity, heart disease, Alzheimer's, etc. "The agent is sugar," he warns. And it's dangerous because it's so delicious.

The conversation raises a lot of questions about the nature of paradigm shifts and the departmentalization of sciences...Taubes blames a lot of the confusion about sugar on the fact that research has been focused in the wrong fields. I was very interested to learn, for example, that by the middle of the 20th century, obesity research was dominated by psychologists, even while endocrinology (which Taubes argues is a more appropriate home for such research) was coming into its own. The focus naturally was behavioral- change the way fat people behave, and they'll slim down. There seems to be plenty of evidence, anecdotal and empirical, that this isn't the case. Taubes maintains that by both looking to other fields and to the history of nutrition research, the answer is clear. (But you'll have to listen or read the highlights for the full explanation...)

Naturally, the episode has me thinking about sugar consumption in my own family... Happily, we're thus far free of many of the health concerns Taubes cites, but like Russ, I'd be happy to drop a few pounds... Have any of you made changes along the lines Taubes proposes ("jack up the fat!")? If so, did it work, and more interestingly perhaps, did it stick?

COMMENTS (11 to date)
Garrett M writes:

Check out Stephan Guyenet's (an obesity researcher) critique too:

E.W. Howe Fan writes:

I stopped eating sugar 20 years ago, along with artificial sweeteners. I never cheat on the sugar (although occasionally I have an artificially sweetened mint), and am never tempted to. I don't drink fruit juices, alcohol, or artificially sweetened beverages.
Over those 20 sugar-free years, I have gone from 2-3 migraines a month to zero migraines a month. Not only that, but I don't get any kind of headache whatsoever any more. Not even a simple tension headache. (I can't overstate how much this has improved my quality of life.)
I am over 64 years old and have a vigorous 40 minute workout 4 days a week. I am able to run up five flights of stairs, two at a time and find it exhilarating. I never get sick, even though I work in a hospital. My mood is stable and generally cheerful. Weight is no problem, and i have far-less to no dental caries. All other health indicators are better than average for my age.
Correlation is not causation, of course. And not drinking may contribute to the anti-headache and mood stability affects. But I'm completely happy with the no-sugar lifestyle, and heartily recommend it.

Evan writes:

Have followed Taubes' work for years and for a long time tried to moderate my carb intake, but wasn't a stickler. Would still drink beer on the weekends, eat carbs at restaurants, etc. That approach didn't leave me in good health. Had many of the markers of metabolic syndrome--210 lbs at 6', hypertension, nearly 40 inch waste, off the chart triglycerides. Also had elevated ALT liver enzymes, suggesting fatty liver. All of this likely caused by insulin resistance.

I got serious about cutting the carbs in March of last year. Went full on LCHF/keto meaning pretty much no carbs outside of green vegetables and trace amounts of sugar in the dry wines I would drink and stuck to it day in and day out. In six to eight months, lost 50 pounds, 8 inches on my waist, saw triglycerides fall from over 400 to 80, and liver enzymes returned to normal. I don't count calories and I'm not hungry.

Making the no carb diet a rule rather than a guideline has made it easy to stick to. No decision fatigue, no guilt, no agonizing over whether it's ok to eat something. I just skip the rice, pasta, potatoes, sugar, period. I've yet to find a restaurant where I can't make the proper substitution to conform to this diet, and I've found polite ways to warn friends about it if I'm eating at their house. (By now everyone I associate with just knows, which makes it even easier to stick to.)

I'm constantly trying to learn more about the human metabolism so I can really dig into the debate between the it's-all-calories crew and the carbs-make-you-fat rule. Until I can really feel comfortable with the science, I just take comfort in the fact that my personal experiment is going swimmingly.

Lliam writes:

I've not yet listened to this (though I will), but note that Taubes' claims are not uncontroversial.

I would certainly recommend the following link as supplementary reading to the interview.

btfine writes:

After being directed to Phil Maffetone (via Christopher Mcdougal's Natural Born Heroes), I was sold on his approach to a high fat, very low carb diet. Mainly because I have a family history of diabetes and as far as that goes it makes a lot of sense.
I dropped a fair amount of weight initially and when I am consistent with his guidelines feel better in general, but most noticeably after meals.
Having 3 kids and a wife with a sweet tooth however makes it challenging to not have slips, which have the expected results...

Lee W. writes:

All diets tend to fail but the low-carb diet is the easiest I've found to stick to because there is not even mild starvation required and no calorie counting, which makes it very easy to plan meals and avoid cheating. Once you kick the sugar/carb habit after a few weeks, weight loss (when combined with just moderate exercise) is fairly easy to achieve and maintain. In addition, you begin to experience higher energy levels akin to a mild caffeine buzz and actually enjoy exercising (or at least enjoy it more than before). You will begin to feel more like you did as a kid.

RPLong writes:

There is a right way and a wrong way to do this. I think some people who cut out sugar end up loading up too much on senseless other problematic foods, especially animal fats, which are known to carry a lot of toxic non-nutrients.

Removing excess sugar, sodium, and processed carbohydrates is always going to be a good idea if you replace those foods with fresh vegetables and sane portions of lean-ish meats and whole grains. But I don't think it's a good idea to basically eat nothing but chimigangas-minus-the-toritilla or bacon lettuce wraps all the time. If more people did the smart version of the low-sugar diet, I think we'd be a healthier species.

Jim Glass writes:

As a person who lost 75 pounds and has kept it off (five years so far) -- according to my doctor "turning every risk factor into an anti-risk factor" -- I can report my own practical experience is 100% opposite from Taubes' position, far more in line with Guyenet's critique of him. For instance, I've done it all on a high-carbs diet.

It's not just my experience. At the National Weight Control Registry, where the average person has kept 66 pounds off for over five years, the overwhelming majority did on a high carbs diet. The reason is simple, the really overwhelming majority (>90%) have done so using the standard "diet and significant exercise" combination - and carbs provide the energy needed to fuel the exercise. (The most common successful diet plan is 'whatever I want that stays within my calorie limit'.)

There is a bit of a paradox that goes often overlooked in the "diet & exercise" combo. At the Registry very few people succeeded via diet alone and almost nobody did via exercise alone. Yet together they are the magic combination. How do two strategies for failure add up to such success when combined? It is certainly *not* because exercise burns off additional fat -- running an entire 26.22-mile marathon burns off about only 3/4th of a pound worth of calories, and before doing so one loads up on carbs then afterward is hungry and feasts out.

The answer is that the exercise changes behavior to reduce the desire for food consumption, plus changes its desired composition, making the formation of new eating habits much more easy. One can imagine that the body shifts to a new equilibrium, or that people get addicted to feeling better, or runner's high, whatever. There are reams of new research coming in that aerobic exercise literally changes the brain, not only 'rewiring' it but making it grow larger (with a multiplicity of benefits). And it is a proven appetite suppressant according to many studies, for instance. This entirely *is* my experience.

But Taub rejects the brain science, quoting Guyenet:

Taubes argued at length that food reward has nothing to do with obesity, and (remarkably) that the brain itself is unimportant

Any book that rejects so much science *and* successful practice, IMHO, is maybe best fit for ... well, I don't want to get into ad hominems again.

Face it, nobody in America (certainly no fat American), eats too much because of "hunger". Hunger looks like this. What American's take for hunger is an "urge", and urges are a matter of psychological conditioning. Think how often we administer food when not hungry at all: to enjoy being with friends, ease anxiety, treat ourselves, keep the kids quiet, keep busy watching TV... we condition ourselves.

The key to successful weight loss and keeping it off is re-conditioning behavior so it is *not* a fight to keep weight off, the new weight is natural.

I started by following the standard steps of gradually increasing exercise (jogging) up from nothing, setting a calorie count and keeping a daily log of diet, exercise and weight -- essential feedback for behavioral change. I ate chocolate ice cream and Oreos as a reward (conditioning) at the end of every day I stuck to plan. It was a serious challenge for about four months then suddenly, like going over the crest of a hill, became easy. My initial dream was to lose 50 pounds but when I got to 40 decided "this feels so good I'm going to keep going, what next? How about trying a half marathon?" Now I've run five full marathons, run about three hours a week for fun, consume all the pizza and beer I want, my weight stays where it is by itself, and I feel 20 years younger. You don't know how much 50+ pounds weighs on you until it's not there any more.

OK, my experience is a mere single anecdote. But my advice to anyone who wants to lose fat is: forget about changing to a diet that you'll have to fight forever to stay on so you'll lose in the end; instead make an effort to change your behavior in a way you'll enjoy forever in the end.

Hazel Meade writes:

I have cut almost all refined sugar out of my diet.
I don't even put artificial sweeteners in my coffee anymore, due to the possible similar effects on the gut microbiota. It's hard to say, but I think I have become a little more interested in eating fruit as a result, which is a healthy improvement.
I still haven't given up chocolate, which is my one vice. Occasionally I'll have a piece of pie or a pastry for dessert instead, but I still pretty much have the one serving of sugar a day after dinner. No junk food.

Partially, this is to avoid simple carbs in general, but I did read the NYTimes piece on sugar a few years ago, so it was a significant motivator too. So my diet right now is: only water or unsweetened tea or coffee, carbs are for breakfast only - but only whole grains - whole grain toast, whole grain pancakes, oatmeal. Lunch is a snack in the afternoon. Dinner is low-carb and has at least one leafy green and a protein. No white rice. No bread. Brown rice or potatos on rare occasions.

I don't miss drinking sodas or other sugary drinks. On rare occasions I'll get a craving for lemonade, and will mix a batch and water it down by about 50%. I don't really miss white rice or potatos, cause I do eat brown rice and potatoes every once in a while (maybe once a month). I don't really miss white bread, it's boring anyway.

I didn't really jack up the fat, but I just don't avoid it so much. I'll eat things like quiche for breakfast instead of pastries. I use butter in cooking and on vegetables and don't feel guilty about it. I eat a lot of avocado, which has a high healthy fat content.

The fruit thing though... the latest thing I've been doing is having an oatmeal-quinoa bowl for breakfast with yogurt on top, fruit on top of that, toasted nuts, and then honey to finish it off. It's delicious and I crave it better than pancakes. So part of me thinks that giving up sugar made my tastes change a bit so I'm eating some healthier sources of fructose.

C L writes:

Another anecdote: I gave up sugar as completely as possible (outside of a few pieces of fruit a week). I did this in October of last year and have kept it up since then. I'm 40 years old. My weight hasn't changed (I'm not overweight, so I wasn't doing this to lose weight in any case), and I don't really feel any different at all.

Ben Kates writes:

I have been in ketosis for 40 days now. I'm fairly fit and was about 10-15 pounds over weight. I have dropped most of the vanity weight and my energy levels have improved.

Still, I'm what you might call a "foodie." This diet or lifestyle, whatever you choose to call it, has completely abolished the pleasure of food for me. The cravings for a plethora of cuisines still plague me. The first week was hell! Since then it has gotten easier but not by much. Going out to eat, in the past a highly anticipated pleasure, is now just blah. Cooking at home, the same. Part of me recognizes that this diet may save me from Alzheimer's, strokes, heart attacks or cancer but on the other hand, life (for me) isn't as fun without good food.

I imagine there may be some way to balance this but I am deathly afraid that if I cheat I'll have to again go through the detox I went through during the first week. That was no fun.

If there are any ketogenic dieters that cheat out there please let me know your thoughts. Thanks

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