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David Katz, M.D.

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The Politics of Sugar

Posted: 05/01/11 01:33 PM ET

We -- Americans, and ever more of the global population -- eat too much sugar, and eating too much sugar is bad for us. ("Too much" of anything is bad for us, hence the name.)

One of the reasons we eat too much sugar is because high-fructose corn syrup can be derived inexpensively from subsidized corn. An inexpensive sugar source makes it economical for food manufacturers to add copious amounts of sugar to our diets. The more sugar we get, the more we eat, and the more we want. So high-fructose corn syrup is an important reason we eat too much sugar, and eating too much sugar is bad for us. That, in turn, is why high-fructose corn syrup is bad for us; because it contributes to our excessive sugar intake. What makes HFCS bad is far more about quantity, than quality.

Qualitatively, HFCS and table sugar -- sucrose -- are all but identical, both biochemically and metabolically. Sucrose is comprised of pairings of glucose and fructose in a 1:1 ratio. HFCS can have a bit more fructose than glucose, or vice versa, but averages out very close to that same 1:1. Swapping out sugar for HFCS, or the opposite, is a lateral move -- and not one for which food manufacturers deserve any credit or thanks.

That's just about the whole story, stripped of any sugar coating.

Since my recent post on sugar, I've "enjoyed" comments from many of you; learned lots of new things about hummingbirds; entered an ongoing and spirited dialogue with Dr. Robert Lustig I look forward to continuing; shared in a briefer and slightly-less-cordial exchange with Gary Taubes; and have had cause to rethink my indulgence in literary flourishes.

The take-away messages here are too important to get lost in a sauce of hummingbirds and breast milk.

All nutritionists of any standing recognize that an excess of sugar is among the cardinal problems of the typical American diet (and other diets resembling it around the world). I know of virtually no nutrition or health professionals who fail to recognize this.

Further, formal guidance to limit intake of added sugar is provided by the Dietary Guidelines for Americans; the Dietary Reference Intakes of the Institute of Medicine; the World Health Organization; the American Dietetic Association; the American Diabetes Association; the American Cancer Society; the American Heart Association; the American Academy of Pediatrics; and just about everybody else.

So there is nothing remotely newsworthy in noting that an excess of sugar is harmful. To get headlines on this topic, you have to be more provocative than that. Others say sugar is bad -- maybe news can be made by claiming that sugar is poison, whether or not it's true. (Since sugar, in the form of glucose, is manufactured by our bodies and circulates in our blood, labeling it 'poison' is intrinsically problematic.)

Dr. Lustig, in his video and his published work, emphasizes the unique potential harms of fructose as opposed to sugar in general. Leaving aside the legitimacy of the case against fructose, the question arises: how is it relevant? Much of the sugar in the food supply is either sucrose, or high-fructose corn syrup. They may sound very different, but as noted above, they are not. Both are roughly half fructose.

As for fructose on its own, it's found in fruit, which is clearly not a problem, and fruit juice, which can be when consumed in excess, but is much less of a problem than soda. So then, on what basis is there an indictment of fructose to be made?

Hard on the heels of all this sugary hullabaloo came a report in the Journal of Consumer Research telling us this:

"...'healthy' consumers who strive to eat a wholesome and healthy diet may become so focused on trying to eat well that they become more likely to choose unhealthy foods that are labelled as healthy. "

I have seen this many times, so it comes as no surprise to me. In fact, the very notion that more nutritious foods inevitably cost more is actually urban legend, propagated by food labeling. Food that claims to be, or implies it is, more nutritious, reliably does cost more -- because the shopper seeking out better nutrition is willing to spend more to get it. But often, perhaps more often than not, such food is more expensive, and less nutritious! Talk about adding insult to injury.

This is not merely my opinion; we've studied it. Using objective criteria to distinguish more from less nutritious foods, we found no net difference in price.

We have also seen, in the course of applying the NuVal scoring system to roughly 100,000 foods, innumerable examples where the product implying better nutrition on the basis of one nutrient attribute has lesser nutritional quality overall. One prime example of this is low-fat peanut butter, from which a bit of healthy oil is removed, and to which a lot of sugar and salt are added. On the NuVal scale, regular peanut butter scores a 20 on average; low-fat peanut butter scores a lamentable 7. Another example was a "1/3 less sugar" cereal, that did have less sugar- but also less fiber, more sodium, more trans fat, more starch, and poorer overall nutrition! A clear example of the dangers in vesting all dietary ills in any one nutrient.

Then, of course, there is the recent history of diet trends. We just cut fat, and got fatter and sicker because our diet quality did not improve. We just cut carbs, and repeated the folly. We might, now, just cut sugar, or fructose, and play it again, Sam. The ONAAT fallacy is a real and recurrent threat.

You might well find the case against sugar convincing. But T. Colin Campbell makes a similarly compelling case against animal protein. I recently had a discussion with Dr. Caldwell Esselstyn at a conference at the Cleveland Clinic, and he showed every sign of having as elaborate an argument prepared against lecithin.

If there are multiple contenders for the single nutrient that is public health enemy #1, the logical conclusion is that none is. If researchers who focus on alternative metabolic pathways can use them to indict alternative nutrients as causes of epidemic obesity and related chronic disease, it strongly suggests that no one such indictment may be taken too seriously. We should round up all of the usual suspects!

The reality has always been, and remains, that the overall quality of our foods, and our diets, is what matters to our health. Competing theories about which bad thing is worst, or which good thing is best about our diets have long distracted us, and may simply forestall progress in a favorable direction.

Let's not let that happen...again.

Dr. David L. Katz; www.davidkatzmd.com
www.turnthetidefoundation.org

 

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We -- Americans, and ever more of the global population -- eat too much sugar, and eating too much sugar is bad for us. ("Too much" of anything is bad for us, hence the name.) One of the reasons...
We -- Americans, and ever more of the global population -- eat too much sugar, and eating too much sugar is bad for us. ("Too much" of anything is bad for us, hence the name.) One of the reasons...
 
 
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02:41 PM on 05/19/2011
"Sugar is sugar" ala the Corn Refiners:
"…because they are nearly compositionally equivalent, the human body cannot tell the difference between high fructose corn syrup and sugar."

but maybe not...

HFCS (55%) has 10% more fructose than table sugar, a large difference that will impact metabolism. Besides that, lab testing done at the University of Southern California showed that bottled full-calorie soft drinks from the major beverage companies had fructose estimates of 64-65%, which equates to 18% higher fructose consumption compared to HFCS 55, and about 30% higher compared to sucrose.

And remember, get the facts--HFCS is anything but natural, wouldn't exist without corn subsidies, was never thoroughly tested, and is difficult to eat in "moderation" because it's in so many foods and beverages.

A suggestive experiment done at Princeton showed rats gained belly fat when fed HFCS but not when fed sucrose. Mercury contamination and reactive carbonyls (diabetes) have also been found in HFCS.

Finally, the rise of obesity correlates perfectly with introduction of HFCS in the 70s. Before that there was about a 15% rate of obesity, today it's about 35%.

It's the elephant in the room. Let's do some definitive research on HFCS so that we really know what's going on here. It may be 40 years late, but never mind.... If it's really so safe, then the Corn Refiners' Association should be calling for impartial studies done by the FDA in collaboration with respected universities.
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HUFFPOST SUPER USER
Gregory Ashby
the health maestro
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HUFFPOST SUPER USER
Gregory Ashby
the health maestro
08:18 PM on 05/12/2011
Here are some interesting abstracts: http://www.ncbi.nlm.nih.gov/pubmed/21539509
http://www.ncbi.nlm.nih.gov/pubmed/21537444
http://www.ncbi.nlm.nih.gov/pubmed/20631048
http://www.ncbi.nlm.nih.gov/pubmed?term=does%20High%20fructose%20corn%20syrup%20effect%20ghrelin%20and%20leptin
CONCLUSION:

These short-term results suggest that, when fructose is consumed in the form of HFCS, the measured metabolic responses do not differ from Sucose in lean women. Further research is required to examine appetite responses and to determine if these findings hold true for obese individuals, males, or longer periods.
So question is does this hold true in the obese??
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Parkite
Still haven't found what I'm looking for
07:59 PM on 05/06/2011
To say that there is NO BAD FOOD is simplistic and untrue in that the stuff that is sold to us is not actually food in the way that nature intended and in the way food has historically been deemed to be food. HFCS is a manufactured food stuff and is not processed in the body/liver the same way sugar or other naturally derived sugar is processed. It acts on the liver in a similar manner as alcohol. It does not trigger "satiety" as does sugar, honey, etc. Exactly what is healthy about adding HFCS to processed crap so people will eat more of it? I believe we have an epidemic of obesity and conditions brought on by malnutrition at the same time. GMOs that have insecticides inserted into them are causing harm to humans, animals, and the environment. Transfats, another manufactured "food" stuff that does more harm than good. These and other artificial food stuffs are one part of our health care crisis. Penny wise and pound foolish. People have to eat real food.
06:29 PM on 05/02/2011
Thank you for having a problem with people calling sugar poison-whether it comes from high fructose corn syrup or refined sugar from sugar cane or beets. You deserve an award for writing that NO SINGLE INGREDIENT is the be-all and end-all of our diets. It’s trendy to find a whipping boy in nutrition, but that doesn’t make it scientific.
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aurora59
Sarcasm: just one of the many services we offer
04:56 PM on 05/02/2011
Thank you Dr. Katz!! What a relief and a joy to read your comments!! How very brave of you to state that no one thing in our diets, no, not even that dreaded sugary stuff, is the root of all evil! A fact that most rational, thinking people, without an agenda or ax to grind, have know for hundreds of years.

I have found myself to be at my healthiest, both in weight and in how I feel, when I follow a sensible diet that includes a wide variety of foods. And yes, even, shall I say it? Sugar! I have never felt worse in my life, than when I spent 6 months on a low carb diet.

I REFUSE to be hoodwinked into spending a fortune in the grocery store on the latest fad diet and/or just because something is labeled, or currently considered, "healthy". Particularly when the scientific studies of today, all too soon become the scientific silliness of yesterday.

Hype, it's all hype. Most of it's last years news, repackaged as something new and different, that will solve the ills we've struggled with for generations. Atkins Diet anyone? Oh no, it's South Beach Diet now. Or is even that passe'? Natural? Oh, no, we call it organic. Not to mention the fear mongering! High fructose corn syrup, sugar, agave! Lions and tigers and bears!! OH MY!
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SuperMom101
What's on your plate?
04:44 PM on 05/02/2011
Dear Dr. Katz,

With all due respect, a few comments:

"What makes HFCS bad is far more about quantity, than quality." Could it be both quantity and quality? A scientist with a PhD in chemical engineering needs to manufacture high fructose corn syrup. If it's not in my kitchen cabinet or something I can make on my stove with the kids...it's not food.

"Formal guidance to limit intake of added sugar is provided by"...The America Heart Association (AHA). Hmmmmm....the AHA allows "a little red dress on diet coke cans" in support of "women's heart health programs". Sounds like a thinly veiled infomerical to me.

Meanwhile, America (and her children) have never been fatter or sicker and we can't seem to figure out why.

Common sense is not so common. - Voltaire
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Parkite
Still haven't found what I'm looking for
07:35 PM on 05/06/2011
HFCS is also processed differently b the liver and not in a good way.
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12:39 PM on 05/02/2011
Frankly, I'm disappointed by the misleading comparisons made in this article.

It is true that the high fructose corn syrup most commonly used in processed foods (HFCS 55) has an approximate 1:1 fructose:glucose ratio, and it is also true that sucrose has an exactly 1:1 fructose:glucose ratio. However, the author is neglecting to mention that in sucrose, the glucose and fructose are chemically linked. Sucrose is a disaccharide; high fructose corn syrup is a blend of two monosaccharides.

This is a very important distinction, and it's intellectually dishonest to imply that the composition alone makes them nearly identical. When digesting sucrose, there's a delay as in uptake as the disaccharide is broken down into its monosaccharides. Fructose, being a monosaccharide already, is taken up immediately.

In layman's terms, sucrose is a huge log of firewood, and high fructose corn syrup is kindling. Yes, it's true that they're both made of the same material, but they burn quite differently. The same goes for sucrose and HFCS. It's misleading to suggest otherwise.

PH
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omsandi
11:56 AM on 05/11/2011
Great info, I didn't know about the chemical link difference... Thanks!
12:25 PM on 05/02/2011
HFCS is NOT like other sugars at all.

HFCS causes sugar diebetes this was directly proven in studies.
http://www.sciencedaily.com/releases/2009/03/090303123802.htm

HFCS confuses the body and sticks in the liver because the body is not set up to deal with it. It has the same effect as drinking too much alcohol.
http://articles.mercola.com/sites/articles/archive/2010/01/02/HighFructose-Corn-Syrup-Alters-Human-Metabolism.aspx

HFCS causes diabeties, obesity and metabolic syndrome. It is a chemically derived imitation sugar that uses genetically modified enzymes to change the starch over to sugar. It is in no way similar to food or sugar as we historically know it. It is an abomination. I am an obese man with diebetes that thought all sugar was the same. Now I have to live with the negative impact of this industry lie.
10:13 AM on 05/02/2011
Have you eaten canned corn lately? It is way way too sweet. Corn has been genetically sweetened until it is repulsive. Adds on seed packets of corn stress how sweet it is encouraging us to believe that sweet, or sugar, is the best taste. I don't think so.
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Carl Caroli
I just don't understand people
09:01 AM on 05/02/2011
Stop subsidizing sugar with tax dollars. It would do us all a world of good physically and economically..
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sabelmouse
i love to tumble , ask me why .
07:11 AM on 05/02/2011
a german dentist wrote a book about the effect of sugar on teeth and was sued into bankruptcy by the sugar industry. that was in the seventies. i've not heard much about sugar's harm full effect on teeth since. apples ans acids , yes. i have come across leaflets at the dentist's claiming the sugar does no harm at all as long as we brush and see the dentist. printed by MARS. my trust is long gone.
05:33 AM on 05/02/2011
For over a decade there has been much talk of US childrens' obesity problem stemming from eating junk food. While I agree, I am also astonished that I have never seen an expert or lay person include in these discussions that a major contributing factor is that all the children are required to sit, physically inactive, throughout most of the school day. Let them out for a measly 10 minute recess and they are running all over, climbing, chasing like mad--then the bell rings and it is back to the desk for hours more. Anyone can watch this at any playground M - F. Basic nutrition/physiology states that weight gain or loss is the ratio of caloric intake vs caloric expenditure. I call into question either the astuteness or ethics of these 'expert' commentators and the educators that ignore this problem.
06:58 AM on 05/02/2011
Good point in some countries the kids have 45-50 minutes classes and 10-15 minutes break, when they can move and run around..they are in the same room the whole day, so the break is time to enjoy the "freedom".
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David Katz, M.D.
Director, Yale Prevention Research Center; Editor-
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conservicide
I don't play nice.
12:57 AM on 05/02/2011
Kill industrial food companies is the surest way to keep our population's bellies from exploding
12:16 AM on 05/02/2011
HFCS is NOT processed the same by our bodies as regular glucose. Although I will agree the worst offender for pretending to be a healthy food is anything labeled "low fat". As long as it's not saturated fat and chock full of cholesterol it's ok, even though we can really only absorb a specific amount of cholesterol per meal anyway.
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DrP
10:03 PM on 05/02/2011
There is no evidence that saturated fat causes any health problems. Sugar, grains, and starches, on the other hand, have been scientifically shown to cause most of the "diseases of civilization." Read Gary Taubes.