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The Case Against Sugar

The case against sugar got another big boost, thanks to this study published in the February 27 issue of the online journal PLoS One. The peer-reviewed study provides strong evidence that increased sugar consumption leads to increased prevalence of Type 2 Diabetes (t2D).

The study examines data from the United Nations Food and Agricultural Organization and the International Diabetes Federation regarding the availability of sugar and prevalence of diabetes in 175 countries over a ten-year period. Results of the study indicate that increased access to sugar is associated with increased rates of diabetes, even when obesity is factored out. According to the study, for every 150 added sugar calories consumed (e.g., a 12-oz can of Coke), the rate of diabetes increases by 1.1%.

The study’s lead author, Stanford University's Dr. Sanjay Basu, concludes, “The bottom line is that this is one of several studies from independent scientific groups that have questioned the old mantra that ‘a calorie is a calorie.’ Some calories may be more metabolically harmful than others, and sugar calories appear to have remarkably potent properties that make us concerned about their long-term metabolic effects."

Another of the study’s authors is Dr. Robert Lustig, a pediatric endocrinologist at UC San Francisco. Dr. Lustig has been building the case against sugar for years. In 2011, his work was featured in the attention-grabbing New York Times Magazine cover article Is Sugar Toxic? His 2009 lecture Sugar: The Bitter Truth has over three million views on YouTube (two of those are mine - there’s a lot to absorb). In that video, Dr. Lustig details the science behind his concerns about sugar, specifically fructose. He explains that excessive intake of fructose – which is added to both refined sugar and high fructose corn syrup – increases insulin production which, in turn, disables the satiety hormone leptin. Instead of understanding that we’re full, our brains get the message that we’re hungry – starving, in fact. As a result, we eat more, expend less energy, and gain weight.

Dr. Lustig goes on to explain that much like alcohol (and unlike glucose), fructose can be metabolized only by the liver. Chronic, excessive fructose consumption over-taxes the liver and leads to non-alcoholic fatty liver disease and ultimately to chronic metabolic diseases such as obesity, hypertension, heart disease and type 2 diabetes.

I find Dr. Lustig’s work, including the aforementioned PLoS study, enormously encouraging. Positive food policy changes are beginning to feel inevitable. I am hopeful that fewer people might develop chronic metabolic diseases, including type 2 diabetes. And certainly for those of us already affected by diabetes (of whichever form), life will be less conspicuous, less isolating, and generally easier to cope with when the food landscape contains less added sugar.

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