Just a spoonful of sugary drink confusion

SugarAre sugary drinks to blame for obesity and diabetes or have they been simply served up by the media, politicians, and even some scientists as a scapegoat for all of society’s ills?

In recent months, the question has sparked harsh words, flared tempers, op-eds, demonization, and even talk of creating policy that would ban or limit consumption of sugar-sweetened beverages like sodas. But what does the scientific evidence really show once emotion and exaggeration are removed from the equation?

With the intent of setting the scientific record straight, respected academics and nutrition researchers came together to discuss the issues in Boston on Tuesday, April 23, at Experimental Biology 2013. The symposium, organized by the American Society for Nutrition, would be the second of its kind over two years at the conference to evaluate sugar and how it relates to health. The event was sponsored by the Corn Refiner’s Association (CRA) and endorsed by the Medical Nutrition Council.

Exaggerated and “emotion-raising” statements

Biostatistician David Allison, MD, a professor at University of Alabama at Birmingham, addressed how misinformation in the peer-reviewed literature and the media about sugar and sugary drinks has spread confusing messages to the public. He called out several examples of how studies with an epidemiological design have reported their findings in exaggerated ways. Many of these trials have found only ecological correlations linking sugary drink consumption to rising obesity numbers. Correlations are the weakest form of evidence and don’t establish causation. There are also correlations linking the rise in bottled water consumption and obesity, for example, he said.

However, despite discovering only weak associations in their data along with inconsistencies, many of these studies are titled in ways that inflate their findings and they use language that suggests causality. Examples he gave include “Sugary beverages represent a threat to global health” (Popkin),”Public health: The toxic truth about sugar (Lustig), and “Fructose: pure, white, and deadly. Fructose, by any other name, is a health hazard.” (Bray). These examples have “emotion-raising” language that leads to further exaggerations and inaccuracies in press releases and in articles by journalists, Dr. Allison said. The most recent example of an article with exaggerated statements, Dr. Allison told me after the event, is one from Bloomberg entitled “Daily Soft Drinks Raise Diabetes Risk by 22%, Study Shows”.

“There’s no surprise that people are confused,” Dr. Allison said. “Imagine you’re a newspaper reporter with no scientific training reading these titles trying to write an article that will inform regulators and the public about sugar-sweetened beverages. You think cause and effect has been demonstrated when in fact it’s only a correlation.”

In addition, as there is a tendency for studies sponsored by industry to show bias, Dr. Allison reminded that there also exists “white hat bias”—a systemic bias among academic scientists that leads to exaggerating findings from their data. “When you look at the peer-reviewed literature, there are multiple demonstrable biases and inappropriate statements that serve to exaggerate,” he said.

The standard for acting or creating policies is subjective and depends on the situation and one’s values and judgments, he said. In contrast, the standard for drawing a conclusion about causation requires randomized controlled trials. Are there any? Yes, Dr. Allison said there do exist several randomized controlled trials that evaluate sugar-sweetened beverages and changes in body weight. Some do show, he concedes, that within the context of additional calories sugary drinks may lead to weight gain.

Dr. Allison makes clear he’s not “advocating” sugary drinks. He agrees that it makes common sense for individuals wishing to lose weight to limit their intake of sugary drinks and other nonessential kilocalories. However, he maintains that the current evidence testing whether reducing sugary drink consumption reduces body weight in consumers has shown only equivocal effects. “As scientists and scholars, we can and should hold ourselves to higher standards,” he said.

Solids versus liquids

Purdue University professor of nutrition science Richard Mattes, Ph.D., believes that sugary drinks do lend to increased risk of weight gain in ways beyond their contribution of calories. He’s not so much concerned with the sugar content of sugar-sweetened beverages; the problem, he said, is the difference in the way those calories are consumed—as liquids versus solids. “When we consume beverages, our bodies are incredibly quick at processing and excreting them. A calorie is not a calorie anymore.”

Citing research from his own lab and that of others, Mattes explained that the evidence suggests that the body’s sensations in response to clear beverages are different in comparison to solid food. For example, when hungry our bodies sense that they want to eat food until full, but our bodies tend to be relatively thirsty all day long. There is a strong “stop” signal and a weak “go” signal when eating solid foods, he suggested. In the case of clear beverages, the opposite is true: there is a weak “stop” signal, and a strong “go” signal.

These sensory signal differences of clear beverages also don’t appear to apply with viscous energy-dense beverages such as soups or liquid meal-replacements. The reason may due to the pattern in which viscous energy-dense beverages are consumed. They are usually consumed in a regimented way, such as at a specific time of day. The dietary pattern that people use to consume clear beverages, on the other hand, is often as frequent as snacking. It’s not because people are eating more food, it’s the change in the way they’re eating their food, Mattes explained.

Frequent sugary drink consumption and the rise of obesity and diabetes in the U.S. has nutritional biologist Kimber Stanhope, Ph.D., an associate project scientist at UC Davis, alarmed despite lack of sufficient evidence establishing causation. She said that while adequately powered clinical trials and longer interventions are needed, she questions why it would be necessary to avoid acting now. “Do we need to wait for these results before we revise the dietary guidelines and start educating the public accordingly?” she asked.

In randomized controlled trials that Stanhope’s lab has produced, sugars—whether as table sugar, high-fructose corn syrup, glucose, and fructose—all comparably increase body fat in subjects when consumed in excess. She also presented data showing that pure glucose versus pure fructose consumed in excess may behave differently in the body. Pure glucose, for example, led to increases of subcutaneous adipose tissue (fat just under the skin) while fructose led to increases of visceral adipose tissue (fat around the organs), which may contribute to increased insulin resistance and cardiovascular risk. Notably, her research also shows that when comparing high-fructose corn syrup and table sugar, these don’t show changes related to body composition suggesting that the metabolism of glucose and fructose behaves differently when consumed together.

Sugar on the brain and addiction

Stanhope also pointed out that glucose and fructose may have different affects on the brain. For example, she cited a recent study published in JAMA (Page et al) that showed glucose consumption promoted appetite suppression in the brain whereas fructose did not. The study has been a source of much speculation regarding whether or not the fructose moiety of sugar and high-fructose corn syrup could be addictive versus other types of carbohydrates.

Nutritional neurologist Miguel Alonso, MD, believes that functional MRIs (fMRIs) as used in the JAMA study and others can indeed be useful for studying brain regions that are involved in decision making and reward aspects of both drugs and food. He also finds interest in the clinical overlap between obesity and drug addiction. For example, there is evidence of a shared vulnerability for the two because of genetic predisposition.

However, Dr. Alonso said that the notion that sugar or any other particular food component is addictive is highly speculative and based on weak and limited evidence. Addiction is highly complex and generally defined by several criteria in an individual that involve tolerance, withdrawal symptoms, lack of control, and interference with daily activities, he said. He also questions what findings can be drawn from fMRI studies that compare fructose versus glucose.

“There is limited and insufficient data in humans on the link between food, obesity and addiction. Brain overlaps do exist, but that does not equal addiction,” Dr. Alonso said. “Recent fMRI data suggest neuroadaptation following repeated intake of palatable food, including sweetened beverages. There is a need to clarify the link, particularly experimental interventions.

Experimental studies are needed to clarify associations found in cross-sectional studies related to the brain, he said. A study by Burger and Stice, for example, found an association between frequent consumption of ice cream and a reduction in sensitivity in regions of the brain related to food reward. These studies lead to questions about how long it takes for neuroadaptations to occur, how specific these changes are, and how they contribute to eating patterns under normal conditions. Dr. Alonso said that while some recent fMRI data suggest different acute brain responses in response to fructose versus glucose, there is still need for research that includes normal conditions of intake and behavioral correlates to better interpret the findings.

Cardiologist Jame Rippe, M.D., founder and director of the Rippe Lifestyle Institute and professor of biomedical sciences at the University of Central Florida, whose organization has participated in funding Dr. Alonso’s pilot research, said that new studies using tools such as functional MRI to study the brain were lending interesting results. But he said that it’s not surprising that areas of “the epicenter of where decisions come to pass” would “light up,” or become active, in response to sugar or any other carbohydrate-containing foods. “It makes all the sense in the world, since the brain relies on glucose,” he said.

However, he said that the speculation about how different sugars—high-fructose corn syrup, sucrose, glucose or fructose—are handled by the brain and talk of addiction feels like, as Yogi Berra once said, “déjà vu all over again.” He reminded of similar arguments he’s made before in previous years as a CRA consultant. It has been a challenge, he said, to educate consumers that the way high-fructose corn syrup and table sugar (sucrose) are treated in the body is the same metabolically, as supported by several randomized controlled trials. And, it’s also been a challenge to help people understand that fructose and glucose are “always consumed together” in a normal diet. One cannot make too much of studies using high amounts of pure glucose or pure fructose whether it be in animals or humans. When consumed together, their absorption and metabolism are different.

What about dose?

Dr. Rippe added that the way sugars are treated in the body has been well studied and regulators and health organizations should take note of that. And he praised the scientists at the event and ASN for coming together to speak out against inaccuracies reported in the peer-reviewed literature and the media.

In addition, Dr. Rippe took issue with the American Heart Association (AHA) for coming out with a statement recommending that sugar be limited to only 150 Kcal per day for men and 100 Kcal for women. The recommendation is only about a third of what has been set by the Institute of Medicine in current Dietary Guidelines for Americans. The IOM dictates, yet does not recommend, that up to 25 percent of kilocalories (Kcal) can be consumed safely from added sugars.

“The AHA has acknowledged that their recommendation wasn’t based on any definitive proof, just their thoughts,” Dr. Rippe said. He added that the IOM recommendations were based on actual evidence from the current literature.

But he said his lab “put the AHA recommendations to the test” anyway. Rippe’s lab conducted a trial that randomized subjects to diets consisting of either 8, 18, or 30 percent of total Kcals from added sugars. Despite consuming roughly four times more than AHA recommendations, the subjects in the group consuming 30 percent added sugars did not show any difference in cardiovascular risk factors as compared to the other groups (including blood lipids, leptin, ghrelin, or fasting insulin). The evidence suggests there are no dangers in consuming sugars up to 25 percent of Kcals within the context of an energy-balanced diet. Some will point out that the study was funded by the CRA and should not be trusted, but Dr. Rippe’s results are corroborated by other randomized controlled trials in the literature.

After the symposium, I spoke to Friedman School professor of nutrition Edward Saltzman, who chaired the event, who said to me that his reaction to the meeting could be summarized as, “I believed every speaker.” That poses a problem, he added, because of from a distance it’s easy to understand why the general public remains more confused due to conflicting evidence on sugar-sweetened beverages. “The issue is far from resolved,” Saltzman said.

Making the medicine to go down

The day after the event, I spoke to professor of nutrition and metabolism David Jenkins, M.D., who told me that he thought more attention should be given to the work of nutrition researcher John Sievenpiper, M.D., of St. Michael’s Hospital, University of Toronto. He said Dr. Sievenpiper “has an army of researchers combing the literature” on sugar and its effects on health.

Dr. Sievenpiper is the lead author of several meta-analyses (of which Dr. Jenkins is often listed as a co-author) comparing sugars on different parameters related to metabolism and body weight. As discussed in my prior interview with Dr. Sievenpiper, these meta-analyses found no differences in the effects of fructose, glucose, or other carbohydrates on several parameters on body weight, blood lipids, and blood pressure. In addition, Dr. Sievenpiper’s research suggests a marked benefit from fructose for glycemic control when consumed in amounts normally found in fruit.

Dr. Jenkins said that he did agree with the thrust of some researchers—such as Walter Willet, M.D., and David Ludwig, M.D.—to recommend that the public reduce consumption of sugary drinks in general when they are identified as providing excessive calories in people’s diets. However, the Atwater Lectureship recipient disagrees with attempts to force reduced consumption using warning statements or regulations.

Most well recognized for developing the low-glycemic index concept, Dr. Jenkins also suggested that sugars be used as put by Mary Poppins, “to make the medicine go down.” More to the point, he said people should use sugar strategically in combination with nutrients that would otherwise “taste like cardboard,” like viscous fiber. Present in several vegetables and whole-grain foods, viscous fiber is not often thought of as palatable, however, it is shown in studies to slow down the rate in which sugar and other carbohydrates are absorbed, reduce total and LDL cholesterol, as well as increase satiety (the feeling of fullness). “If I could get people to eat ‘cardboard’ by itself I would, but put a little sugar on it, a little salt, or a little fat, and people will eat it,” he said.

Whether Dr. Jenkins would approve of washing down steel cut oats, asparagus, or Brussels sprouts with a bottle of Mountain Dew or any other brand of soft drink, he didn’t exactly say. But it may be worth a try for those who have a sweet tooth and who wouldn’t include these highly beneficial foods in their diets otherwise.

Update – 5-17-13 – The videos from the ASN session have just become available, so here they all are for your enjoyment (by order of appearance):

Author: David Despain, MS, CFS

David is a science and health writer living on Long Island, New York. He's written for a variety of publications including Scientific American, Outside Online, the American Society for Nutrition's (ASN) Nutrition Notes Daily, and Institute of Food Technologists' (IFT) Food Technology magazine and Live! blog. He's also covered new findings reported at scientific meetings including Experimental Biology, AAAS, AOCS, CASW, Sigma Xi, IFT, and others on his personal blog "Evolving Health." David is also an active member of organizations including the National Association of Science Writers (NASW), the American Association for the Advancement of Science (AAAS), the American Society for Nutrition, the Institute of Food Technologists, and the National Audubon Society. David has a master's degree in human nutrition from the University of Bridgeport, and a bachelor's degree in English from University of Illinois at Springfield. He also earned his Certified Food Scientist credential from the Institute of Food Technologists.

29 thoughts on “Just a spoonful of sugary drink confusion”

  1. The same could be said about all epidemiological studies/papers on dietary fat, red meat, whole grains, vegetarian and vegan diets, cholesterol, statins and all the rest. There’s bias and agenda behind each one, whether it’s conscious or not. Follow the money.

    Cheers

    1. I was also interested in seeing Dr. Allison’s featured list, which included this RCT with surprise surprise “No Effect of Replacing Sugar Sweetened Beverages with Water on Weight Loss in Women.” http://www.fasebj.org/cgi/content/meeting_abstract/27/1_MeetingAbstracts/855.10?sid=cc7ce292-e797-4423-8227-aea88ac989ce

      Subjects compensated with calories from other sources. Goes to show that, as is the case with studying effects of other foods on body weight, obesity can be more complex than thought.

      David

      1. My experience has been you have to cut out “all” white refined sugars to effect weight loss with success … it will literally melt off.

  2. Gary Fettke has said you have undeclared conflict of interest in this field. Could you confirm or deny this. I note that you quote Dr Rippe who has consulted for the Corn refiners association without revealing his conflict of interest .

    1. Julian, I’m glad you asked me directly as opposed to believing whatever people have said. I want to be absolutely clear that I’ve never received compensation in any shape or form from the CRA, Pepsico, Coca-Cola, or Monsanto for that matter. I was careful to note in my article that the event was sponsored by CRA and that the Rippe/Alonso research received CRA funding; however, you’re right in that I didn’t clarify Rippe’s consulting relationship. I’ve corrected that in the article now, so thanks. My own conflcts of interested are listed in my “about” section; I realize that previously I had it as a bullet point, but now I’ve separated it into its own section. Ironically, the nutrition-focused companies I list are of the kind that are anti-HFCS and anti-sugar (although they do use some “natural” sugars) and usually are rallying against the ones above like the CRA. As for myself and I hope you’ll agree, as I write, I am simply trying to make sense of all the science myself as I go along. Personally, I have never as a nutritionist recommended sugary drinks to anyone because of their empty calories. However, I do confess to enjoying the occasional Dr. Pepper of root beer float.

      1. Then try doing one about all the Bromides in everything Including Asthma meds. They only destroy the Thyroid and we all get Fat Slow and Stupid.
        The History goest back to the 40’s and the US army Knew.
        SO why change the Breads and Pizza doughs etc in the 80’s?

    2. Julian has taken up the challenge (led by his guru) to try and find any conflict of interest (even belonging to an association that has sponsorships) in order to totally dismiss anything that anyone ever says without having to read it. Whether one is the author of a meta-analysis or even reporting on that meta-analysis – if Julian can find a conflict – he thinks he has debunked ALL of the content.

      His guru David Gillespie has one of the worst of these to his credit (the fact that poisoning the well is regularly employed in law but not in science is lost on both of them) – if you can find some small industry link, you can discredit – see Attack of the chocolatier – http://www.raisin-hell.com/2010/01/attack-of-chocolatier.html

      Julian also regularly asks for evidence (which he isn’t interested in, he’s just looking to confirm his own experience, especially regarding fructose) and thus has developed a reputation for asking questions and then disappearing when someone goes to the effort of replying. Don’t waste your time David with his veiled accusation!

  3. I point to an increasingly common likelihood that medication has weight gain as common side effects with the rising obesity rate. Blaming sugar is silly. When you eat foods, your body will chemically process it into sugar so you can metabolize it! The only problem with sugar is that one, you will become malnourished if that’s all you eat. Two, it’s very difficult to control portion sizes of sugar. Sugar doesn’t make you feel full in the same way as a ham sandwich or a bowl of steamed broccoli and rice.

    1. Agreed. I had no weight problems until a doctor prescribed something with weight gain as a listed side effect. Without changing my diet/exercise habits, I was gaining 10 pounds a month, 50 pounds total. Adding insult to injury, the prescription didn’t do what it was supposed to. Nearly 10 years later, I still haven’t been able to lose the weight; the metabolic change is apparently permanent.

  4. If sugary drinks and food cause obesity and bad health, then I would be very large and very unhealthy. I am 55 years old and have consumed sugar at a ridiculous rate since my early teens and I feel healthy and can still run with ease. I think the sugar scare is a lot of nonsense.

    1. Same here! I’m 54, and eat sweets as if they were 3 of 4 of the ‘basic food groups’, yet people tell me I look 20 years younger, I have no weight problems, I walk as fast as most people jog, AND… my Doc just told me last month that all the blood work, etc, shows my health to be akin to someone half my age. (Did I mention I drink cream?)

  5. Jeez, that CRA doesn’t give up easily when it comes to peddling that HFCS SHITE, does it? These are the things I know for sure as a type 2 diabetic:
    1) Comparing a refined sugar product to natural fructose-containing fruits is absurd. Fructose in fruits is sequestered in little fibrous parcels which limit the rate at which the sugar is presented to the digestion. Consumption of orange: no real plasma glucose bump. Drinking orange juice: dramatic increase in blood sugar. In the same way, HFCS-sweetened beverages just like beverages sweetened with cane sugar will result in an unhealthysurge in blood sugar promoting AGE chemicals and sticky vessel plaques.
    2) Even more horrid than that, fructose is a monosaccharide which has been shown to have the ability to infiltrate cells WITHOUT an insulin gatekeeper. This the reason that pure fructose seems to raise the serum insulin level less than glucose. Contrary to dietary sugar reduction, which decreases insulin secretion, the fructose effect here is NOT A DESIRED EFFECT FOR DIABETICS. Excessive levels of sugars within the cell lead to high levels of intracellular Advanced Glycation Endproducts and Mitochondrial damage.
    3) Still trying to sell this crap as “corn sugar”? The CRA conveniently forgets that we already have natural corn sugar. It has NO fructose in it, and I guess it isn’t nearly as sweet as sucrose, which is why they need to chemically modify it to contain fructose. Creating markets for human consumption of chemically modified corn sugar diverts some of the sugar away from corporate animal farming, and diverting some excess sugar away from the livestock business would have been good actually for animals raised on corn mulls if they weren’t raised ass-deep in their own excrement,by pretty much the same corporate entities trying to peddle this crap to us.

  6. I read an article recently about a teenage girl who’s only diet for many years, (I don’t quite recall accurately but it was something between 8 to 13 years) was ramen noodles; the store bought dehydrated in either a styrofoam cup or plastic bag. In that case, the professional commenting on the consequences said she would have major health problems and a sorter life expectancy if I am recalling correctly. My question is, even though she would be getting the caloric intake needed to survive, what would be the consequences of not having a more diverse diet, with the additional assumption of if someone had that diet but supplemented a multivitamin daily? More specifically, would the multivitamin compensate for any of the dietary needs that were not fulfilled with the ramen-only diet? If anyone can offer any insight I would greatly appreciate it.

  7. I am not an MD nor am I a dietician (sp?). But try this, make a gallon of lemonade with just enough sugar to balance the tartness. measure the sugar. If you are working outside in the south, add a small pinch of iodized salt. Noting how much sugar you added, look at a can of your favorite sugar sweetened soft drink. they are between 150 and 200 calories each. restaurant sugar packets are about 18 calories each. approximately 10 packets per can. a lot more than you put in the lemonade. I would wager.

  8. Sugar is an easy target. Just like one of the causes of obesity in America. Here is a correlation for you. What states have the highest rates of obesity? I’ll guess it’s in the Midwest. The mid-west had another problem in the past that caused obesity. Way in the past. Here is the correlation. I’ll bet that in the same areas with high obesity rates, there is also a high rate of depression. I have been working on a study for a few years now and have found something interesting. The big obesity problem in America kicked off at about the same time as all the studies on how bad salt is. Everyone was told to cut down on salt intake. The one thing everyone forgot is salt is one of the only sources of iodine in some people’s diets, especially in the Midwest. As researchers you would think that if a population became deficient in iodine, there would be an increase in goiters. The one thing everyone forgets. Iodine is a halogen. Fluorine is a halogen. America added fluorine to drinking water. When you are deficient on iodine fluorine can bind on the same position of T-4, and T-3. The only problem with this is that your body has no ability to break the fluorine bond. It is too strong. This means that there is thyroid hormone that your body cannot use (Plaque). Fluorine wouldn’t really be a problem at the low levels of 4ppm in drinking water, except for one thing. In the 90s the president signed a law forcing all beverage companies to use fluoridated water. That’s another argument all together, so back to my point. I will bet that iodine deficiency has more to do with the obesity problem than sugars. Also iodine deficiency is a cause for depression, stunted growth, chronic fatigue, fibromyalgia, fungal infections, immune deficiencies, and a multitude of other ailments. I found this correlation while researching veterans of modern warfare. Many war veterans coming home from combat zones, since the Gulf War, are suffering from severe anxiety, chronic depression, and multiple pain syndromes, at much higher rates than veterans from past wars. I asked myself, why? What did veterans from the past have, that today’s veterans don’t. That was pretty easy to figure out since I am a Gulf War veteran. In the wars for the last hundred year’s right up until the Gulf War, veterans used iodine. They had salt tablets for cramps, iodine tablets for water purification, and they used iodine to treat small wounds. Now we send troops overseas for years on end with no ability to get iodine. They eat MRE’s for the entire deployment, and are told to cut salt intake. The only time they get iodine is if they get shot, or get surgery, because the doctors use it. I wondered why injured veterans came home with less emotional problems or chronic pain conditions. I tracked it down to iodine deficiency.

    1. Your statement on problems associated with iodine deficiency and the history of iodine with military deployment is very interesting. I had thought that Gulf War syndrome may be more than one syndrome, with a variety exposures as potential culprits: depleted uranium, pesticides to kill sand fleas used to the point of dripping off the canvas tents, the blowing up of a depot of chemical weapons, the required series of vaccinations given in rapid succession, and the breakdown of aspartame in diet sodas that were left on pallets in the desert heat to be chilled just before consumption, with formaldehyde being a resulting toxic in the soda. I hadn’t heard of iodine deficiency causing this raft of ailments, only goiter. Now I’m wondering of the packaging on the MRE’s when exposed to heat may taint the food inside, plus perhaps some of the preservatives used could be injurious to health, particularly after repeated exposure to temperatures as high as 140 degrees.

      1. Originally I thought GWI had something to do with the Hep B vaccine they gave us just before the ground war. Because after we received it so many of us got sick that they ordered the entire 1st Marine division to start taking cipro 500mg X2 daily. many of us were showing symptoms of encephalitis right after the Hepatitis B vaccine.

  9. David,

    I’m late to the party but I really must comment. This was a frustrating read. If anything it simply illustrates the limitations of depending on small-scale studies, focusing on interesting details, and missing the big picture.

    Citing one study about 9 overweight women (did they already have an unhealthy relationship to food?) says NOTHING about the large-scale, population-wide, epidemiological consequences of increased sugar consumption, available at little energy cost, or financial cost – and uncoupled from any nutrient value!

    Regarding the appetite-suppressing qualities of glucose….I wish I had known that when I binged consistently on sugary, fatty foods. I would have said to myself, “Gee, I’m not supposed to be doing this. The glucose is supposed to suppress my appetite. Where did that 6th eclair go?”

    Yes, some people are actually capable of eating that much sugar (and fat). Perhaps those of you who don’t just don’t get it.

    I do agree that using catchphrases such as “sugar is poison” and “sugar kills” and “sugar IS addictive” (as opposed to “can be”) is distracting and unhelpful.

    But I’m a little tired of hearing the phrase “it’s more complicated” used to obscure some simple, home truths.

    1. Diana,

      I appreciate your thoughts on this. The epidemiological studies have already received a lot of coverage in the media. David Allison went through many of them at this event. However, as reported in the post, he pointed out that these studies show only weak correlations with obesity and chronic disease.

      RCTs are necessary to determine causation. And those appear to find that there’s little evidence that drinking sugar-sweetened beverages is detrimental in comparison to other sources of carbs/calories.

      That is not to say that sugar-sweetened drinks have played no role in causing obesity in this country. On the contrary, I believe Richard Mattes’s evidence is pretty convincing in finding that the pattern in which we drink these clear beverages frequently leads to overconsumption of calories.

      However, I do believe that there is a case for stopping with the anti-sugar/anti-SSB hysteria and presenting arguments on both sides in a balanced way. I feel like my post attempts to do that and that, from a nutritionist’s perspective, David Jenkins’s addition that we use sugar in a way that helps improve our nutrition is important to consider.

      David

  10. blah blah blah … my third eye tells me HCFS is bad without having even think about science. They’ve taken a natural product and chemically modified it so they could make more money. Simple as that. There’s no extensive testing done on either side of the fence nor could there be because of the all the factors involved. It’s impossible to say with certainty what this chemically altered product will do to every human body that consumes it over an infinite amount of time. Nature had already taken care of producing some sweetener for us. It’s called natural sugars. They’re natural because they developed naturally alongside us and there was no money involved. It’s quite simple.

  11. In regards to the response to Diana, the notion that these sugary drinks contributes to excess calories is likely the most important point. As a diabetic (a little under, not overweight) I find that consuming carbohydrates of any kind will increase blood glucose levels, it’s just a matter of how long it takes to digest. Drinks, boiled foods like white rice and spagetti digest very quickly compared to raw foods and whole grains, and perhaps some fruits which have the fiber as discussed. What is really more confusing to any reader is that the negative opinions or those shading toward discrediting the anti sugar arguments are the lead in to the more accurate and real liklihood that there is good cause for decreasing sugar in our diets by a large factor. Does anyone, including the author, question the sponsorship of the -what was it, a symposium? by the Corn Refiners Association. This sort of discussion should be taken with more than a grain of salt.

  12. Gee, you mean what my award-winning doctor has been telling me, about molecules of complex carbohydrates possibly damaging the capillaries in my eyes and kidneys is a bunch of nonsense? I wonder if I should believe him, or a so-called researcher from a state that depends heavily on sugar production.

    Chuck: You claim “there’s bias and agenda behind each one, whether it’s conscious or not,” but with out knowing each one, how would you know? Speak for yourself–which is what I think you’re doing (i.e., projecting). And when you say “follow the money,” you can’t just glibly assume that what motivates you applies to everyone else, especially in science. Ever hear of a person deciding to major in science in order to get rich? Once again, those who’ve pursued careers in order to get rich are projecting, assuming that scientists are like them when they aren’t. Sure, scientists go after grants. That’s what they have to do to survive in unbiased environments. Everyone has to justify their existence at some level. There’s no escaping that reality. The problem scientists have is that biased, politically-minded people are trying to take even survival away from them.

  13. Sugar does not cause diabetes and is not unhealthy for diabetics. As with everything else there needs to be moderation. Anything in excess will kill you. Thanks for this article. It is nice to get some nutritional truth, because there is very little anywhere.

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