If you haven’t done so, Gary Taubes has a new article out on the history of the sugar industry that is worth a read. It is well written and the comparisons to the tobacco industry are eerily similar. Even more disturbing, according to the article, is how the sugar industry has been able to influence government policy and therefore public health policy during the past several decades. This influence extends to influential organizations such as the American Diabetes Association as well:
It is hard to overestimate Bierman’s role in shifting the diabetes conversation away from sugar. It was primarily Bierman who convinced the American Diabetes Association to liberalize the amount of carbohydrates (including sugar) it recommended in the diets of diabetics, and focus more on urging diabetics to lower their fat intake, since diabetics are particularly likely to die from heart disease. Bierman also presented industry-funded studies when he coauthored a section on potential causes for a National Commission on Diabetes report in 1976; the document influences the federal diabetes research agenda to this day. Some researchers, he acknowledged, had “argued eloquently” that consumption of refined carbohydrates (such as sugar) is a precipitating factor in diabetes.
If you go to the ADA’s website, they have a “Diabetes Myths” section to educate Americans on Diabetes “facts.” TheFatNurse finds this fact on the website about Type 2 Diabetes pretty interesting:
Pretty conventional stuff right? Being overweight is a risk factor and drinking sugared beverages is associated with Type 2 diabetes. Not too clear whether the ADA is trying to say the weight gain from consuming sugary drinks (which are high calories) is a risk factor for developing diabetes or if it’s the intake of high amounts of sugar in the drinks that leads to risk factors for diabetes. TheFatNurse is guessing it’s the former rather than the latter since the consumption of candies, ice cream, and other sugar added foods is not discussed. It seems the focus is only on sugared beverages. Does this mean a person can replace their sugar fix they get from coke with a bag of skittles instead to reduce their risk of diabetes!? Why all the focus on sugar added drinks and not the other sugar added junk foods!?
What you may find interesting is that the “Myth” fact on the ADA’s site was recently changed. In September 2012, TheFatNurse happened to take a screen shot of the previous statement on the myth that eating too much sugar causes diabetes:
So at least since September 2012, before the new changes mentioned earlier, the ADA was telling people that its ok to drink as much soda as you want provided you keep your weight under control? This was then changed to include warnings of sugar from sodas sometime between october and november 2012. This is strange considering a 2010 Meta-analysis from Diabetes Care, which is associated with the ADA, showed these links between sugared beverages and diabetes two years before the ADA decided to adjust their myths page. This meta-analysis also seems to hint that sugar’s damaging effects go beyond just causing obesity and a high amount of sugar by itself may lead to effects (SSB = sugar sweetened beverages):
Because of the high content of rapidly absorbable carbohydrates such as sucrose (50% glucose and 50% fructose) and high-fructose corn syrup (most often 45% glucose and 55% fructose), in conjunction with the large volumes consumed, SSBs may increase the risk of metabolic syndrome and type 2 diabetes not only through obesity but also by increasing dietary glycemic load, leading to insulin resistance, β-cell dysfunction, and inflammation
Although SSBs increase risk of metabolic syndrome and type 2 diabetes, in part because of their contribution to weight gain, an independent effect may also stem from the high levels of rapidly absorbable carbohydrates in the form of added sugars, which are used to flavor these beverages.
Exploring the links between sugar consumption and diabetes is nothing new. This debate started decades ago. From the Taubes article:
An international panel of experts—including Yudkin and Walter Mertz, head of the Human Nutrition Institute at the Department of Agriculture—testified that variations in sugar consumption were the best explanation for the differences in diabetes rates between populations, and that research by the USDA and others supported the notion that eating too much sugar promotes dramatic population-wide increases in the disease.
To be clear, one shouldn’t assume cause and effect with high sugar consumption and the development of diabetes. The statement from the ADA, “the answer is not so simple” is actually pretty accurate since the evidence isn’t quite conclusive yet, although there are some pretty strong associations. There are many factors and the significance of this subject deserves exploration of all its complexities. However, the “not so simple” response should have been the standard answer a long time ago rather than saying sugar has no role.
Additionally, Dr. Lustig (mentioned in the Taubes article) has been mentioning potential links between sugar consumption and metabolic syndrome (in which one of the criteria is impaired fasting glucose) for awhile. If you are not familiar with his name, I recommend watching his famous Sugar Lecture at UCSF which covers history, policy and biochemistry on sugar:
Things are changing tho and it seems TheFatNurse sees more and more public service campaigns advocating the reduction of sugars such as the “real bears” on youtube:
However, as mentioned previously, why such a focus on the sugar in sodas and not other sugar added foods like candy or kids breakfast cereals? Regardless, TheFatNurse is happy to see the conversation on the dangers of sugar progressing.