Take Out Sugar

Chapter summary

• Removing added sugar is the first and most important step in managing weight. Treat added sugar as harmful as alcohol, whether you are fat or thin.
• The idea is old. Brillat-Savarin wrote in 1825 that avoiding flour and starch reduces body fat.
• “Sugar is the new tobacco.” Books by Lustig, Gillespie, Taubes, Moss and Sarah Wilson have made it a popular cause.

Five things to remember

• Glucose is essential, but you hold only about 5g (one teaspoon) in your blood. Too little or too much is dangerous.
• Fructose acts like alcohol. A glass of wine is fine, but a bottle a day kills slowly. The author says there is no safe level of added fructose.
• Simple carbohydrates (sugar, white flour, rice, potato) are the main cause of fatness in Western diets. They are converted to glucose and used or stored as fat.
• Sugar and refined carbohydrate drive cardiovascular disease, diabetes, fatty liver, chronic kidney disease, cancer and dementia.
• Dietary fat is not the problem.

The evidence

• Metabolic syndrome (a cluster that raises diabetes and heart risk) emerged in the late 1970s as obesity rose.
• Utah researchers fed mice 25% extra sugar, equal to a human diet plus three cans of soda. Female mice were twice as likely to die or have fewer young, and males held fewer territories (Ruff 2013).
• Professor Robert Lustig says sugar is “not about the calories”. He calls it a poison.
• Added sugar is hidden in nearly all packaged food.

The case against this view

• Hard to separate: Few studies separate fructose, sugar and carbohydrate. All carbohydrates are broken down to simple sugars before absorption.
• Poor evidence: Epidemiological studies show only correlation. The gold standard is the randomised double-blind trial, and few exist.
• Mice are not people: Animal results may not transfer.
• Calories: Many researchers say sugar’s harm is mainly extra calories.
• Time lag: Metabolic harm may take 5 to 20 years, so a 3-month study will not show it.
• Vested interests: Food and drug companies shaped past research.
• The author’s evidence: Atkins, Paleo and South Beach dieters all cut sugar and most simple carbohydrate. When he did 5:2, he cut 70% of his carbohydrate. Insulin is the common link.

Action list

• Stop eating added sugar in any food or drink.
• Do not eat anything that is more than 3% sugar.
• Eat no more than two or three pieces of fruit a day.
• Eat as many leafy green vegetables as you like.
• If overweight, go very low carbohydrate and consider intermittent fasting.

Take-away points

• Nutrition policy focused on low fat, which the author says helped create the obesity pandemic.
• The marketing, money and habits behind sugar are deeply set.

References

• Lustig, R. (2012) Fat Chance: The Bitter Truth About Sugar. HarperCollins.
• Taubes, G. (2008) The Diet Delusion.
• Moss, M. (2013) Salt Sugar Fat. Random House.
• Gillespie, D. (2013) Sweet Poison. Penguin. (2012) Big Fat Lies. Penguin.
• Wilson, S. (2012) I Quit Sugar.
• Ruff, J.S. et al. (2013) Human-relevant levels of added sugar consumption increase female mortality and lower male fitness in mice. Nature Communications 4:2245.