At Virgin Pure we want to help our customers live a healthier life, which is why we have found this recent article in the Guardian so interesting. Indeed, have you ever imagined that your indispensable ally could actually be a threat? In fact sugar, this dear friend who was there for almost every moment in your life, could bring with him disease, lack of concentration, addiction, and more. For hundreds of years doctors, physicians and neurologists have highlighted the health risk of over-consumption of sugar, so why are we still craving for another piece of chocolate?
Is sugar the world’s most popular drug?
Sugar, more than anything, seems to have made life worth living (as it still does) for so many, particularly those whose lives lacked the kind of pleasures that relative wealth and daily hours of leisure might otherwise provide. Sugar was “an ideal substance”, says Mintz. “It served to make a busy life seem less so; it eased, or seemed to ease, the changes back and forth from work to rest; it provided swifter sensations of fullness or satisfaction than complex carbohydrates did; it combined with many other foods … No wonder the rich and powerful liked it so much, and no wonder the poor learned to love it.”
What Oscar Wilde wrote about a cigarette in 1891 might also be said about sugar: It is “the perfect pleasure. It is exquisite, and it leaves one unsatisfied. What more can one want?”
Children certainly respond to sugar instantaneously. Give babies a choice of sugar water or plain, wrote the British physician Frederick Slare 300 years ago, and “they will greedily suck down the one, and make Faces at the other: Nor will they be pleas’d with Cows Milk, unless that be bless’d with a little Sugar, to bring it up to the Sweetness of Breast-Milk”.
One proposition commonly invoked to explain why the English would become the world’s greatest sugar consumers and remain so through the early 20th century – alongside the fact that the English had the world’s most productive network of sugar-producing colonies – is that they lacked any succulent native fruit, and so had little previous opportunity to accustom themselves to sweet things, as Mediterranean populations did. The sweet taste was more of a novelty to the English, and their first exposure to sugar occasioned a population-wide astonishment.
This is speculation, however, as is the notion that the taste of sugar will soothe distress and stop infants crying, or that consuming sugar will allow adults to work through pain and exhaustion and to assuage hunger pains. If sugar, though, is only a distraction to the infant and not actively a pain reliever or a psychoactive inducer of pleasure that overcomes any pain, we have to explain why, in clinical trials, it is more effective in soothing the distress of infants than the mother’s breast and breast milk itself.
Research literature on the question of whether sugar is addictive and thus a nutritional variant on a drug of abuse is surprisingly sparse. Until the 1970s, and for the most part since then, mainstream authorities have not considered this question to be particularly relevant to human health. The very limited research allows us to describe what happens when rats and monkeys consume sugar, but we’re not them and they’re not us. The critical experiments are rarely if ever done on humans, and certainly not children, for the obvious ethical reasons: we can’t compare how they respond to sugar, cocaine and heroin, for instance, to determine which is more addictive.
The more we use these substances, the less dopamine we produce naturally in the brain. The result is that we need more of the drug to get the same pleasurable response, while natural pleasures, such as sex and eating, please us less and less.
“There is little doubt that sugar can allay the physical craving for alcohol,” the neurologist James Leonard Corning observed over a century ago. The 12-step bible of Alcoholics Anonymous recommends the consumption of sweets and chocolate in lieu of alcohol when the cravings for drink arise. Indeed, the per capita consumption of sweets in the US doubled with the beginning of prohibition in 1919, as Americans apparently turned en masse from alcohol to sweets.
Sugar and sweets inexorably came to saturate our diets as the annual global production of sugar increased exponentially. By the early 20th century, sugar had assimilated itself into all aspects of our eating experience, and was being consumed during breakfast, lunch, dinner and snacks. Nutritional authorities were already suggesting what appeared to be obvious: that this increased consumption was a product of at least a kind of addiction – “the development of the sugar appetite, which, like any other appetite – for instance, the liquor appetite – grows by gratification”.
A century later still, sugar has become an ingredient in prepared and packaged foods so ubiquitous it can only be avoided by concerted and determined effort. There is sugar not just in the obvious sweet foods – cookies, ice creams, chocolates, fizzy drinks, sodas, sports and energy drinks, sweetened iced tea, jams, jellies and breakfast cereals – but also in peanut butter, salad dressing, ketchup, barbecue sauces, canned soups, processed meats, bacon, hot dogs, crisps, roasted peanuts, pasta sauces, tinned tomatoes and breads.
From the 1980s onwards, manufacturers of products advertised as uniquely healthy because they were low in fat, or specifically in saturated fat, took to replacing those fat calories with sugar to make them equally, if not more, palatable – often disguising the sugar under one or more of the 50 names by which the combination of sugar and high-fructose corn syrup might be found. Fat was removed from candy bars so that they became “health-food bars”, in spite of added sugar. Fat was removed from yoghurts and sugars added, and these became “heart-healthy snacks”. It was as though the food industry had decided en masse that, if a product wasn’t sweetened at least a little, our modern palates would reject it and we would purchase instead a competitor’s version that was.
For those of us who don’t reward our existence with a drink (and for many of us who do), it’s a chocolate bar, a dessert, an ice-cream cone or a Coke (or Pepsi) that makes our day. For those of us who are parents, sugar and sweets have become the tools we wield to reward our children’s accomplishments, to demonstrate our love and our pride in them, to motivate them, to entice them.
The common tendency is, again, to think of this transformation as driven by the mere fact that sugars and sweets taste good. The alternative way to think about this is that sugar took over our diets because the first taste, whether for an infant today or for an adult centuries ago, is a kind of intoxication; it’s the kindling of a lifelong craving, not identical but analogous to the effect of other drugs of abuse.
Because it is a nutrient, and because the conspicuous ills connected to its consumption are benign compared with those of nicotine, caffeine and alcohol – at least in the short term and in small doses – sugar remained nearly invulnerable to moral, ethical or religious attacks. It also remained invulnerable to attacks on grounds of damage to health.
Nutritionists have found it in themselves to blame our chronic ills on virtually any element of the diet or environment – on fats and cholesterol, on protein and meat, on gluten and glycoproteins, growth hormones and oestrogens and antibiotics, on the absence of fibre, vitamins and minerals, and surely on the presence of salt, on processed foods in general, on over-consumption and sedentary behaviour – before they’ll concede that it’s even possible that sugar has played a unique role in any way other than merely getting us all to eat too damn much. And so, when a few informed authorities over the years did indeed risk their credibility by suggesting sugar was to blame, their words had little effect on the beliefs of their colleagues or on the eating habits of a population that had come to rely on sugar and sweets as the rewards for the sufferings of daily life.
So how do we establish a safe level of sugar consumption? In 1986, the US Food and Drug Administration (FDA) concluded that most experts considered sugar safe. And when the relevant research communities settled on caloric imbalance as the cause of obesity and saturated fat as the dietary cause of heart disease, the clinical trials necessary to begin to answer this question were never pursued.
The traditional response to the how-little-is-too-much question is that we should eat sugar in moderation – not eat too much of it. But we only know we’re consuming too much when we’re getting fatter or manifesting other symptoms of insulin resistance and metabolic syndrome.
Insulin resistance is the fundamental defect present in type 2 diabetes, and perhaps obesity too. Those who are obese and diabetic also tend to be hypertensive; they have a higher risk of heart disease, cancer and strokes, and possibly dementia and even Alzheimer’s as well. If sugar and high-fructose corn syrup are the cause of obesity, diabetes and insulin resistance, then they’re also the most likely dietary trigger of these other diseases. Put simply: without these sugars in our diets, the cluster of related illnesses would be far less common than it is today.
Metabolic syndrome ties together a host of disorders that the medical community typically thought of as unrelated, or at least having separate and distinct causes – including obesity, high blood pressure, high blood sugar and inflammation – as products of insulin resistance and high circulating insulin levels. Regulatory systems throughout the body begin to misbehave, with slow, chronic, pathological consequences everywhere.
Once we have observed the symptoms of consuming too much sugar, the assumption is that we can dial it back a little and be fine – drink one or two sugary beverages a day instead of three; or, if we’re parenting, allow our children ice cream on weekends only, say, rather than as a daily treat. But if it takes years or decades, or even generations, for us to get to the point where we display symptoms of metabolic syndrome, it’s quite possible that even these apparently moderate amounts of sugar will turn out to be too much for us to be able to reverse the situation and return us to health. And if the symptom that manifests first is something other than getting fatter – cancer, for instance – we’re truly out of luck.
The authorities who argue for moderation in our eating habits tend to be individuals who are relatively lean and healthy; they define moderation as what works for them. This assumes that the same approach and amount will have the same beneficial effect on all of us. If it doesn’t, of course, if we fail to remain lean and healthy or our children fail to do so, the assumption is that we’ve failed – we ate too much sugar, or our children did.
If it takes 20 years of consuming sugar for the consequences to appear, how can we know whether we’ve consumed too much before it’s too late? Isn’t it more reasonable to decide early in life (or early in parenting) that not too much is as little as possible?
Any discussion of how little sugar is too much also has to account for the possibility that sugar is a drug and perhaps addictive. Trying to consume sugar in moderation, however it’s defined, in a world in which substantial sugar consumption is the norm and virtually unavoidable, is likely to be no more successful for some of us than trying to smoke cigarettes in moderation – just a few a day, rather than a whole pack. Even if we can avoid any meaningful chronic effects by cutting down, we may not be capable of managing our habits, or managing our habits might become the dominant theme in our lives. Some of us certainly find it easier to consume no sugar than to consume a little – no dessert at all, rather than a spoonful or two before pushing the plate to the side.
If sugar consumption is a slippery slope, then advocating moderation is not a meaningful concept.
In my own mind, I keep returning to a few observations – unscientific as they may be – that make me question the validity of any definition of moderation in the context of sugar consumption.
The roots of the modern discussion on sugar and disease can be traced to the early 1670s. Thomas Willis, medical adviser to the duke of York and King Charles II, noted an increase in the prevalence of diabetes in the affluent patients of his practice. “The pissing evil”, he called it, and became the first European physician to diagnose the sweet taste of diabetic urine – “wonderfully sweet like sugar or hon[e]y”. Willis’s identification of diabetes and the sweetness of the urine happens to coincide with both the first flow of sugar into England from its Caribbean colonies, and the first use of sugar to sweeten tea.
We have to acknowledge that the evidence against sugar is not definitive, compelling though I personally find it to be. Let’s say we randomly assigned individuals in our population to eat a modern diet with or without sugar in it. Since virtually all processed foods have sugar added or, like most breads, are made with sugar, the population that is asked to avoid sugar would simultaneously be avoiding virtually all processed foods as well. They would dramatically reduce their consumption of what journalist Michael Pollan, author of books on food, agriculture and drugs, has memorably called “food-like substances”, and if they were healthier, there would now be a host of possible reasons why. Maybe they ate fewer refined grains of any type, less gluten, fewer trans fats, preservatives or artificial flavourings? We would have no practical way to know for sure.
We could try to reformulate all these foods so that they are made without sugar, but then they won’t taste the same – unless, of course, we replace the sugar with artificial sweeteners. Our population randomised to consume as little sugar as possible is likely to lose weight, but we won’t know if it happened because they ate less sugar, or fewer calories of all sorts. Indeed, virtually all dietary advice suffers from this same complication: whether you’re trying to avoid gluten, trans fats, saturated fats or refined carbohydrates of all types, or just trying to cut calories – eat less and eat healthily – an end result of this advice is that you’re often avoiding processed foods containing sugar and a host of other ingredients.
Artificial sweeteners as a replacement for sugar muddy these waters even more. Much of the anxiety about these sweeteners was generated in the 60s and 70s by the research, partly funded by the sugar industry, that led to the banning of the artificial sweetener cyclamate as a possible carcinogen, and the suggestion that saccharin could cause cancer (at least in rats, at extraordinarily high doses). Though this particular anxiety has faded with time, it has been replaced by the suggestion that maybe these artificial sweeteners can cause metabolic syndrome, and thus obesity and diabetes.
As Philip Handler, then head of the US National Academies of Sciences, suggested in 1975, what we want to know is whether using artificial sweeteners over a lifetime – or even a few years or decades – is better or worse for us than however much sugar we would have consumed instead. It’s hard for me to imagine that sugar would have been the healthier choice. If the goal is to get off sugar, then replacing it with artificial sweeteners is one way to do it.
The research community can certainly do a much better job than it has in the past of testing all these questions. But we may have a very long wait before the public-health authorities fund such studies and give us the definitive answers we seek. What do we do until then?
Ultimately, the question of how much is too much becomes a personal decision, just as we all decide as adults what level of alcohol, caffeine or cigarettes we’ll ingest. Enough evidence exists for us to consider sugar very likely to be a toxic substance, and to make an informed decision about how best to balance the likely risks with the benefits. To know what those benefits are, though, it helps to see how life feels without sugar. Former cigarette smokers (of which I am one) will tell you that it was impossible for them to grasp intellectually or emotionally what life would be like without cigarettes until they quit; that through weeks or months or even years, it was a constant struggle. Then, one day, they reached a point at which they couldn’t imagine smoking a cigarette and couldn’t imagine why they had ever smoked, let alone found it desirable.
A similar experience is likely to be true of sugar – but until we try to live without it, until we try to sustain that effort for more than days, or just a few weeks, we’ll never know.
This is an edited extract from The Case Against Sugar, published by Portobello Books (£14.99). To order a copy for £12.29 go to bookshop.theguardian.com or call 0330 333 6846.
Sugar hides in many places you wouldn’t expect to find it. Did you know there is as much sugar in a small takeaway bottle of orange juice as there is in 13 hobnobs?
So, what do you think? Is it time to change your life partner?
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