Saturday, 21 August 2021

A critique of the sugar panic

I've been reading an interesting critique of the current hysteria about sugar published in Critical Reviews in Food Science and Nutrition. Here are some highlights...

The pursuit of power and profit via the demonization of dietary factors such as alcohol and sugar dates to at least the seventeenth century. Thus, as the public’s fear of fat and cholesterol waned and the lipid-heart disease hypothesis began to lose empirical support, it was only a matter of time before media attention, political grandstanding, and research funding were once again directed at dietary sugars. The net result of this shift in attention and resources was an apparent ‘consensus’ that sugar consumption is harmful.

.. because a million matching but ill-informed opinions do not constitute a fact, the anti-sugar consensus, either real or apparent, is not a statement about nutrition science but merely the ‘status quo’ made explicit.

.. the distinctions between ‘added’, ‘free’, and ‘intrinsic’ sugars are scientifically and biochemically mean- ingless. As such, the use of the term ‘added sugar’ in a scientific or health context is misleading. Nevertheless, the ubiquitous use of the term in popular and social media led to ‘added sugars’ becoming “the nutrition villain du jour” (Slavin 2014, p. 4) with subsequent ill-informed changes in the public’s perception of sugar-health relations

Importantly, by recommending breast-feeding, public health organizations are implicitly arguing that infants should consume $40% of their total calories as dietary sugars. Yet these same organizations also recommend that sugar consumption by infants and children be limited. The striking contradiction between the passionate prescription of breast-feeding and the puritanical proscription of dietary sugars is due to the failure to acknowledge that, despite its political expediency and marketing potential, the distinction between ‘added’ and ‘intrinsic’ sugars is bio- chemically and scientifically meaningless.

In the U.S., sugar availability (i.e., a crude proxy for consumption) increased $600% from 18.6 lbs (8.5kg) in 1863 to 125 lbs (57kg) in 1930. The fastest rate of increase in U.S. history was 3 lbs per capita per year (36.1%) from 1918 until 1930. Yet as sugar availability increased exponentially, the U.S. population improved in almost every health metrics (e.g., malnutrition, mortality, health-span) while rates of obesity and T2DM were extremely low.

Diet-centric paradoxes exist because investigators often ignore contrary evidence or refuse to question assumptions that have been demonstrated to be false. For example, there are countries in which sugar and sugar- sweetened beverage consumption declined while obesity and metabolic diseases increased. In Australia, sugar/sweetener availability decreased 18% from 56.2 kg in 1961 to 46.1 kg in 2013 as the prevalence of obesity increased over 450% from more than 5% in the 1960s to 28% in 2015). In the United Kingdom (U.K.) availability decreased 20% from 51.7kg in 1961 to 41.3kg in 2016 while obesity increased over 400% from less than 5% in the 1960s to over 26% in 2016. In the U.S., sugar/sweetener availability declined 18.2% from 69.1 kg per capita in 1999 to 56.5 kg in 2018, as the prevalence of diabetes in adults increased 36.8%, obesity increased 39%; and severe obesity increased 95.7%

The end result of the intellectual decline and corruption in nutrition research has been decades of impassioned but physiologically illiterate disputes about sugar, salt, fat, and cholesterol, increasing confusion about what constitutes a ‘healthy diet’, and the public’s loss of confidence in ‘science’ to inform their lives. 

.. physiology, not food and beverages, causes metabolic diseases. This fact explains why identical diets consumed by different individuals result in divergent nutritional, metabolic, and health effects, and why some individuals can consume massive quantities of sugar and other carbohydrates while maintaining metabolic health, whereas less fortunate individuals develop obesity and/or T2DM. 
We contend that current policy recommendations on ‘added’ sugars and sugar-sweetened beverages are not only unscientific, but also regressive and unjust because they harm the most vulnerable members of our society while providing no personal or public health benefits 


It's paywalled but there are ways and means of downloading it.

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