The Case Against Sugar
Gary Taubes is an award-winning science journalist. He’s a Robert Wood Johnson Foundation Investigator in Health Policy Research at the University of California, Berkeley School of Public Health. In this book, we take up the case against sugar as the primary suspect for ALL of the chronic diseases that are killing us. As the back cover says, Taubes “makes the convincing case that sugar is the tobacco of the new millennium: backed by powerful lobbies, entrenched in our lives, and making us very sick.” Big Ideas we explore include: the prime suspect (= sugar), drug or food?, two theories (energy balance vs. metabolic theory), sugar as a chronic toxin (vs. acute), sugar as candy for cancer cells, and the big question: how little is too much?
Big Ideas
- Sugars as the cause of diseaseAs the cause of disease.
- The Prime Suspect: SugarSugar and Occam’s Razor.
- Sugar as a drugWhich is it?
- Energy balance vs. metabolic theoryEnergy Balance vs. Metabolic.
- Toxins: Acute vs. ChronicAcute vs. chronic.
- Sugar = Cancer candyStop feeding it.
- How little is too much?Is too much?
“The purpose of this book is to present the case against sugar—both sucrose and high-fructose corn syrup—as the principal cause of the chronic diseases that are most likely to kill us, or at least accelerate our demise, in the twenty-first century. Its goal is to explain why these sugars are the most likely suspects, and how we arrived at the current situation: a third of all adults are obese, two-thirds are overweight, almost one in seven is diabetic, and one in four to five will die of cancer; yet the prime suspects for the dietary trigger of these conditions have been, until the last decade, treated as little worse than a harmless pleasure.
If this were a criminal case, The Case Against Sugar would be the argument for the prosecution.”
~ Gary Taubes from The Case Against Sugar
Gary Taubes is an award-winning science journalist. He’s a Robert Wood Johnson Foundation Investigator in Health Policy Research at the University of California, Berkeley School of Public Health. (And, his offices must be pretty close to another health journalist based out of UC Berkeley, Michael Pollan, author of Food Rules and In Defense of Food who says this about Taubes: “I can’t think of another journalist who has had quite as profound an influence on the conversation about nutrition.”)
We covered one of Taubes’s previous books, Why We Get Fat, in which he challenges the commonly accepted “calories-in, calories-out” model of weight maintenance.
In this book, we take up the case against sugar as the primary suspect for ALL of the chronic diseases that are killing us.
As the back cover says, Taubes “makes the convincing case that sugar is the tobacco of the new millennium: backed by powerful lobbies, entrenched in our lives, and making us very sick.”
The book is extremely compelling and well-written. If you’re into this sort of thing, I think you’ll enjoy it as much as I did. (Get a copy here.)
I’m excited to share some of my favorite Ideas that I sincerely hope will open your eyes to the toxic effects of sugar on your and your family’s health so let’s jump straight in!
Download MP3
Download PDFWe are, beyond question, the greatest sugar-consumers in the world, and many of our diseases may be attributed to too free a use of sweet food.
Get the BookSugars as the cause of disease
“This book makes a different argument: that sugars like sucrose and high-fructose corn syrup are fundamental causes of diabetes and obesity, using the same simple concept of causality that we employ when we say smoking cigarettes causes lung cancer. It’s not because we eat too much of these sugars—although that is implied merely by the terms ‘overconsumption’ and ‘overeating’—but because they have unique physiological, metabolic, and endocrinological (i.e., hormonal) effects in the human body that directly triggers these disorders. This argument is championed most prominently by the University of California, San Francisco, pediatric endocrinologist Robert Lustig. These sugars are not short-term toxins that operate over days and weeks, by this logic, but ones that do their damage over years and decades, and perhaps even from generation to generation.”
That’s from the Introduction: “Why Diabetes?” in which Taubes walks us through the EXPLOSIVE growth of the epidemic that is diabetes.
The other argument he refers to in the beginning of this idea that sugar is bad simply because it adds to our caloric load—leading to obesity as a result of the “energy balance” hypothesis that says we need to burn more calories that we consume and that “a calorie is a calorie.”
Taubes’s point throughout the book is that a calorie is NOT a calorie and that, in fact, sugars effect our bodies in very interesting and unhealthy ways.
I got this book after reading Nobel laureate Elizabeth Blackburn’s The Telomere Effect She’s at UCSF and is a colleague of Robert Lustig. I was on Amazon buying Lustig’s book Fat Chance (Note soon) when I saw Taubes’s book and here we are.
Here’s what Elizabeth says about sugars and the fact that a calorie is NOT just a calorie: “When we want to spot the parties responsible for metabolic disease, we point a finger at the highly processed, sugary foods and sweetened drinks. (We’re looking at you, packaged cakes, candies, cookies, and sodas.) These are the foods and drinks most associated with compulsive eating. They light up the reward system in your brain. They are almost immediately absorbed into the blood, and they trick the brain into thinking we are starving and need more food. While we used to think all nutrients had similar effects on weight and metabolism—a ‘calorie is a calorie’—this is wrong. Simply reducing sugars, even if you eat the same number of calories, can lead to metabolic improvements. Simple carbs wreak more havoc on metabolism and control over appetite than other types of foods.”
I am not prepared to look back at my time here in this Parliament, doing this job, and say to my children’s generation: I’m sorry, we knew there was a problem with sugary drinks, we knew it caused disease, but we ducked the difficult decisions and we did nothing.
The Prime Suspect: Sugar
“If this were a criminal investigation, the detective assigned to the case would start from the assumption that there was one prime suspect, one likely perpetrator, because the crimes (all the aforementioned diseases) are so closely related. They would only embrace the possibility that there were multiple perpetrators when the single-suspect hypothesis was proved insufficient to explain all the evidence. Scientists know this essential concept as Occam’s Razor. When Isaac Newton said, ‘We are to admit no more causes of natural things than such as are both true and sufficient to explain their appearances,’ he was saying the same thing that Albert Einstein, three centuries later, said (or was paraphrased as saying): ‘Everything should be made as simple as possible, but no simpler.’ We should begin with the simplest hypothesis, and only if that can’t explain what we observe should we consider more complicated explanations—in this case, multiple causes.”
This is another theme Taubes comes back to throughout the book.
Most researchers describe the occurrence of obesity and diabetes and heart disease and cancer and other chronic diseases of Western civilization as an incredible complex set of problems.
Taubes asks: What if it was a lot simpler? Why don’t we, like good detectives looking at a related pattern of crimes, start from the assumption that ONE prime suspect was responsible?
It’s a good question. And Taubes provides compelling evidence in his “case against sugar” that that’s PRECISELY the way we should be thinking about it.
btw: Here’s how Taubes frames his hypothesis: “So here’s the if/then hypothesis. If these Western diseases are associated with obesity, diabetes, insulin resistance, and metabolic syndrome, which many of them are, then whatever causes insulin resistance and metabolic syndrome is likely to be the necessary dietary trigger for the diseases, or at least a key player in the causal pathway. Because there is significant reason to believe that sugars—sucrose and high-fructose corn syrup in particular, the nearly fifty-fifty combinations of glucose and fructose—are the dietary trigger of insulin resistance and metabolic syndrome, it’s quite likely they are a primary cause of all these Western diseases, including, as we’ll discuss, cancer and Alzheimer’s disease. Without these sugars in the diet, these chronic diseases would be relatively rare, if not, in some case, virtually nonexistent.”
When Isaac Newton paraphrased the concept of Occam’s Razor, he did so by saying, ‘We are to admit no more causes of natural things than such as are both true and sufficient to explain their appearances.’ This was rule number one of Newton’s ‘rules of reasoning in natural philosophy’ in his Principia. So is it necessary to posit multiple aspects of diet and lifestyle—multiple causes—to explain the presence of these chronic diseases that associate with Western and urban lives, or will one suffice? Sugar, for example.
‘We now eat in two weeks the amount of sugar our ancestors of 200 years ago ate in a whole year,’ as the University of London nutritionist John Yudkin wrote in 1963 of the situation in England.
Sugar as a drug
“Sugar does induce the same responses in the region of the brain known as the ‘reward center’—technically, the nucleus accumbens—as do nicotine, cocaine, heroin, and alcohol. Addiction researchers have come to believe that behaviors required for the survival of the species—specifically, eating and sex—are experienced as pleasurable in this part of the brain, and so we do them again and again. Sugar stimulates the release of the same neurotransmitters—dopamine in particular—through which the potent effects of these other drugs are mediated. Because the drugs work this way, humans have learned how to refine their essence into concentrated forms that heighten the rush. Coca leaves, for instance, are mildly stimulating when chewed, but powerfully addictive when refined into cocaine; even more so taken directly into the lungs when smoked as crack cocaine. Sugar, too, has been refined from its original form to heighten and concentrate its effects, albeit as a nutrient that provides energy as well as a chemical that stimulates pleasure in the brain.”
That’s from chapter 1: “Drug or Food?”
Exhibit #1 in regard to the fact that not all calories are the same: As we’ve discussed before (see David Ludwig’s Always Hungry? and the +1: Eating Sugar in an fMRI Machine), sugar lights up your reward center or nucleus accumbens—the same part of your brain that lights up with cocaine, alcohol and nicotine.
Fat calories don’t do that. Protein calories don’t do that. Complex carbohydrate calories don’t do that either. Just sugar. In short, remember: A calorie is NOT a calorie.
This is relevant because we’re building a case against sugar. We’ll see that not only does sugar act like a drug on your reward center, it also does other weird things to your metabolism.
btw: In Bright Line Eating, Susan Peirce Thompson makes the same comparison (adding flour into the mix as well): “When it comes to food, these are the two culprits. Sugar and flour. In fact, I want you to consider looking at sugar and flour in an entirely new way. People tend to think of sugar and flour as foods. I invite you to start looking at them as drugs.”
Energy balance vs. metabolic theory
“The second pillar of modern nutritional wisdom is far more fundamental and ultimately has had far more influence on how the science has developed, and it still dominates thinking on the sugar issue. As such, it has also done far more damage. To the sugar industry, it has been the gift that keeps on giving, the ultimate defense against all arguments and evidence that sugar is uniquely toxic. This is the idea that we get obese or overweight because we take in more calories than we expend or excrete. By this thinking, researchers and public-health authorities think of obesity as a disorder of ‘energy balance,’ a concept that has become so ingrained in conventional thinking, so widespread, that arguments to the contrary have typically been treated as quackery, if not willful disavowal of the laws of physics.
According to this logic of energy balance, or calories-in/calories-out, the only meaningful way in which foods we consume have an impact on our body weight and body fat is through their energy content—calories. This is the only variable that matters. We grow fatter because we eat too much—we consume more calories than we expend—and this simple truth was, and still is, considered all that’s necessary to explain obesity and its prevalence in populations. This thinking renders effectively irrelevant the radically different impact that different macronutrients—the protein, fat, and carbohydrate content of foods—have on metabolism and on the hormones and enzymes that regulate what our bodies do with these foods: whether they’re burned for fuel, used to rebuild tissues or organs, or stored as fat.”
That’s from the chapter called “The Gift That Keeps on Giving.”
That gift? The mistaken belief that a “calorie is a calorie” and that the whole problem with obesity (and all the diseases associated with it) is that we eat too much and don’t move enough.
This perspective allows the sugar industry to avoid taking responsibility for the havoc they appear to be inflicting on our health. (Not unlike the tobacco industry in the 20th century.)
Taubes walks us through how the sugar industry (and the major players within it including Coca-Cola, Pepsi, Hershey’s, Nabisco, etc.) has worked so hard and spent so much money to convince us that sugar is a harmless indulgence. (In fact, the sugar industry actually won a prestigious PR award celebrating its effective campaign to push back a rising negative tide of public opinion.)
It’s painful to read the lengths to which the sugar industry has attempted to (and successfully) manipulated the data and public opinion in their favor. Taubes says: “Almost sixty years later, when the Times reported in 2015 that academic researchers were doing the bidding of Coca-Cola by taking its money to fund a Global Energy Balance Network (GEBN) and ‘shift blame for obesity away from bad diets,’ this was still the argument researchers would invoke in their defense. ‘Mainstream scientists understand that obesity is caused by a calorie surplus due to over-eating or under-exercising.’ And anyone who didn’t know this was either a quack or at best held a ‘fringe view.’”
The alternative view to this energy balance theory? Again: Metabolic theory.
One of the reasons why I love referencing (Nobel Prize Winner) Elizabeth Blackburn and her adamant stance that the prevailing “energy balance” theory is wrong is that, as one of the most celebrated scientists on the planet, she’s very far from the “quacky” “fringe view.”
Here’s a reminder of how Mark Hyman puts it in Eat Fat, Get Thin: “The conventional wisdom doesn’t stack up against the emerging research that shows us that a calorie is not a calorie (when you eat it). In a vacuum or a lab, calories from all foods release the same amount of energy when burned—whether the food is coconut oil or honey. But when you eat, foods have to go through your body, and they can have profoundly different effects on your hormones, brain chemistry, and metabolism. Fat calories burn differently than sugar calories do. Fat calories speed up your metabolism. Fats have to be burned and are not easily stored because they don’t spike insulin—the fat storage hormone. Fat works on the brain to cut your appetite so you eat less overall during the day. On the other hand, sugar and carb calories do exactly the opposite: They spike insulin, promote fat storage, and are quickly laid down as dangerous belly and organ fat. They slow your metabolism and increase hunger and cravings. Mounds of scientific research support this perspective.
This hormonal or metabolic hypothesis of weight gain supports the idea that it is the composition and quality of the foods you eat (and the hormones and biochemistry they subsequently trigger) that determine whether you lose or gain weight. In other words, it is not how much you eat but what you eat that controls the metabolic switches.”
So, again, did I mention that a calorie is not a calorie? Awesome. Remember: Sugar effects your metabolism in some really pernicious ways.
If we are looking for a dietary cause of some of the ills of civilization, we should look at the most significant changes in man’s diet.
‘The human understanding,’ wrote Bacon, ‘once it has adopted opinions, either because they were already accepted and believed or because it likes them draws everything else to support and agree with them. And though it may meet a greater number and weight of contrary instances, it will, with great and harmful prejudice, ignore or condemn or exclude them by introducing some distinction, in order that the authority of those earlier assumptions may remain intact and unharmed.
By now, the message should be clear if insulin is involved in a disease process, then insulin resistance—i.e., metabolic syndrome—is likely to make it worse, and perhaps even initiate the disease process to begin with. This directly implicates sugar as a potential cause, a dietary trigger of the disease.
Toxins: Acute vs. Chronic
“So the answer to the question of whether sugar, in the form of sucrose and HFCS [high-fructose corn syrup], is the primary cause of insulin resistance and metabolic syndrome and therefore obesity, diabetes, and heart disease is: it certainly could be. The biological mechanisms that were elucidated by the 1970s make it clear that sugar is a prime suspect and should have been all along. The damage that these sugars do, their toxicity, would take years to accumulate and manifest themselves as disease. This wouldn’t necessarily happen to everyone who ingested them (just as cigarette smoking doesn’t cause lung cancer in everyone), but the biology suggests that when insulin resistance and metabolic syndrome appear, these sugars are the likely cause. The greater leap of faith, in this case, would be to assume that the sugars are harmless. And if sugars cause insulin resistance, as the evidence suggests, there are all-too-regrettable implications.”
One of the reasons why it’s so hard to point to sugar as the obvious cause of insulin resistance and metabolic disorder which then leads to obesity, diabetes and heart disease is the fact that it’s harm doesn’t show up immediately. It takes years and decades to do its dirty work. Then, BAM! We’re struck down by a chronic disease and left wondering what happened…
Know this: Sugar is a chronic toxin not an acute toxin. It’s kinda like the kryptonite dust (vs. chunks) we talked about in Dave Asprey’s Headstrong. Recall that a great way to slow down Superman (or Superwoman!) is to sprinkle the kryptonite dust around his office and house. He’ll slowly lose his powers. Well, same thing with sugar. We’re literally sprinkling it in EVERYTHING (literally, nearly everything—from the obvious sources like your sugary sodas and candies and cookies to the less obvious sources like ketchup and salad dressing).
If you have metabolic issues, TEST IT! See what happens when you create some bright lines and eliminate sugars. Lean into Michael Pollan’s wisdom: “Eat food. Not too much. Mostly plants.”And, remember, anything loaded with sugar and flour would fall into the “edible foodlike substances” category. Not the food category. :)
As this book will argue, sugar appears to be a substance that causes pleasure with a price that is difficult to discern immediately and paid in full only years or decades later.
Sugar = Cancer candy
“But the other way to initiate the cancer process, according to these researchers, is to increase the levels of insulin and blood sugar in the circulation itself. Insulin resistance would do that. Thus whatever is causing insulin resistance would be promoting the transformation of healthy cells into malignant, metastic cells by increasing insulin secretion and elevating blood sugar and telling the cells to take up increasingly more glucose for fuel.
This leads those like Cantley and Thompson directly back to sugar. As Cantley has said, sugar ‘scares’ him, for precisely this reason. If the sugars we consume—sucrose and HFCS specifically—cause insulin resistance, then they are prime suspects for causing cancer as well, or at the very least promoting its growth. Even if the details of the mechanism should turn out to be wrong, the association between obesity, diabetes, and cancer, and the specific association between insulin, IGF, and cancer, suggests that whatever is causing insulin resistance is increasing the likelihood that we will get cancer. If it’s sugar that causes insulin resistance, it’s hard to avoid the conclusion that sugar causes cancer, radical as this may seem, and even though this suggestion is rarely if ever voiced publicly.”
Sugar as fuel for cancer? (That’s a strong reason to reduce the sugar intake in your family, eh?)
Reminds me of Tom Rath’s wisdom from Eat Move Sleep: “Sugar is a toxin. It fuels diabetes, obesity, heart disease, and cancer. At the current dose we consume, more than 150 pounds per person every year, sugar and its derivatives kill more people than cocaine, heroin, or any other controlled substance around.
One report aptly describes sugar as ‘candy for cancer cells.’ It accelerates aging and inflammation in the body and subsequently fuels tumor growth. It is now clear that if you lower your sugar intake, you reduce your odds of developing cancer.”
‘It would be an extraordinary coincidence,’ as Peter Cleave wrote and we’ve already quoted, ‘if these refined carbohydrates, which are known to wreak such havoc on the teeth, did not also have profound repercussions on other parts of the alimentary canal during their passage along it, and on other parts of the body after absorption from the canal.
How little is too much?
“To understand this tautological logic better, imagine a situation in which cigarette smokers who don’t get lung cancer (or heart disease or emphysema) assume de facto that those smokers who do are those who smoke ‘too much.’ They’d certainly be right, but it still wouldn’t tell us what constitutes a healthy level of smoking or whether such a thing as smoking in moderation even exists. How many cigarettes could be smoked without doing at least some harm to our health, and could thus constitute smoking in moderation? If we say none, we may, indeed, be right, but now we’ve redefined how we’re willing to work with the concept of moderation. The same logic may also apply to sugar. If it takes twenty years of either smoking cigarettes or consuming sugar for the consequences to appear, how can we know whether we’ve smoked or 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?”
“How little is too much?” ← That’s a brilliant question. Best understood by drawing comparisons to cigarette smoking. It takes twenty years to see the effects of smoking. Not everyone will get lung cancer. But… Does that mean we (and our kids) should smoke “moderately”? The idea is absurd.
Of course, the sugar companies have done a wonderful job convincing us that sugar isn’t all that bad for us. (Oh, wait! Didn’t the tobacco companies do that before?) But if you believe the case against sugar that Taubes presents (I do) then it seems prudent to “decide early in life (or early in parenting) that not too much is as little as possible.”
So… Is now a good time to throw away (/quit buying!) the sugary sodas, fruit juices and energy drinks (including Gatorade, etc.) plus the cookies and candies and all the other sugary toxins? Awesome. High fives and vibrant, sustainable health to you and your family!
Ultimately and obviously, the question of how much is too much becomes a personal decision, just as we all decide as adults what levels of alcohol, caffeine, or cigarettes we’ll ingest. I’ve argued here that 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.
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