HomeOut & AboutGary Taubes On The Case Against Sugar Gary Taubes hits us with the truth – and it’s anything but sweet… Is sugar the new tobacco? We chatted with Gary Taubes, co-founder of the Nutrition Science Initiative and the author of The Case Against Sugar, Why We Get Fat and The Diet Delusion. An award-winning science and health journalist, his writing has appeared in Discover, Science, the New York Times Magazine, the Atlantic, Nature and the British Journal of Medicine. We spoke with Gary to learn more about his latest book and why we can’t get enough of the sweet stuff. What inspired the book? I’d been working for a decade already on some of the misconceptions widely disseminated in nutrition and chronic disease research about the nature of a healthy diet. In particular, since the 1960s, we’d considered the defining characteristics of a healthy diet to be low in fat, low in saturated fat, low in salt and mostly plants. In doing so, we left out seemingly the most obvious characteristic, which was low in sugar. I wrote two books about this subject in general — Good Calories, Bad Calories and Why We Get Fat — but clearly there was a need to drill down and focus on the role of sugar, both in individuals and in populations. In this sense, somebody had to write this book and I seemed best placed to do it. What is particularly bad about sugar, in comparison to other carbohydrates? When we eat grains or starchy vegetables, we eventually break them down into the simple carbohydrate glucose. The glucose is transported into the circulation, raises our blood sugar (technically blood glucose) and is then metabolized by virtually every cell type in the body. Sugar (sucrose) is a molecule of glucose bonded to a molecule of fructose. High fructose corn syrup, as we typically consume it, is 55 % fructose, 45 percent glucose. Fructose is the sweetest of the simple carbohydrates. It’s what makes sugar sweet and it’s found in fruit (along with sucrose) to make fruit sweet. This is why fructose is often known as fruit sugar. The fructose is metabolized in our liver, and the problem is that our liver didn’t evolve to handle the amount of fructose it sees all day long. It evolved to deal with the fructose in fruit, which it would see a few months a year when fruit was in season, and see in small doses. Even if apples were in season and our ancestors (up until maybe the 20th Century) decided to binge eat them, it might take them an hour to consume the number of apples necessary to supply the sugar for an 8-ounce glass of apple juice, and then a few hours to digest and absorb the fructose in the apples. Hence, our liver would see the 8-ounce glass worth of sugar trickling in over the course of a few hours, and that would happen only one or two months a year. Now we drink the juice for breakfast. We chase it with the sugar in our coffee and on our cereal. Follow it up with a sugary snack on our coffee break or maybe a sugary beverage and it continues all day long, all year long. When our livers see doses of sugar they can’t handle, they convert it into fat. And I argue (backed by plenty of research) that the fat causes not just non-alcoholic fatty liver disease, which is now epidemic, but a condition called insulin resistance, which leads to obesity and type 2 diabetes and heart disease and, sigh, cancer and probably dementia as well. I realize that this argument puts the Grinch to shame in terms of stealing pleasure from our lives but, as I said, somebody had to lay it out. What is your opinion on the fruitarian diet? I don’t know enough to comment. All I can say is that I could have lived on mostly fruit in my teens and 20s and appeared pretty healthy. I very much doubt I could have kept it up. A common cognitive mistake we all tend to make is to assume that the diet that works for us, works for everyone. The bodies of 30-year-old ultra-endurance athletes work differently than those of us who are predisposed to be fat and diabetic. In general, we tend to store calories as fat and they tend to burn them for energy. As such what works for them might not work for us. And vice verse. It’s a tricky business. As with all diets, extreme or not, including the diet I now eat, if folks starting have chronic health problems on the diet — getting fatter, say, or diabetic or showing signs of deficiency syndromes — then they should seriously consider the possibility that something about the diet needs to be fixed. What are the main dangers of consuming too much sugar? The argument I make in my book is that sugar causes a condition called insulin resistance, which leads over years and decades to effectively every major chronic disease— obesity, diabetes, heart disease, stroke (cerebrovascular disease), cancer and dementia. Then there’s also other relatively minor problems, such as dental caries — i.e., cavities — which are clearly caused by sugar consumption. Why are we so addicted? Well, not all of us are addicted. But sugar does work in a part of our brain called the nucleus acumbens — less technically, the reward center — that rewards with pleasure those activities that help the species thrive — i.e., reproduction and eating. Addictive drugs tend to be substances that also work in the nucleus acumbens and so hijack this reward or pleasure center. Nicotine, alcohol, opioids do that. So does sugar. The only really meaningful experiments carried out, though, have been on lab rodents, and those rodents clearly prefer sugar to hard drugs like cocaine and heroin. Researchers have addicted them to these drugs of abuse and then given them the opportunity to switch to sugar, and they take it. This might explain the well-established observation that alcoholics often switch to sugar consumption as a way to help them stay off alcohol. (Whether it works is a different issue.) What’s interesting is that both alcohol and the fructose component of sugar are metabolized in the liver in very similar biochemical pathways. Since the 1970s, there’s been a hypothesis that I find fascinating, although couldn’t fit into my books, that implicates this liver-centric metabolism in determining whether we’re hungry or not and the nature of our cravings. So this might explain the observation that the very first taste of sugar will fire up a craving for more in some folks — me, for instance — very similar, I imagine, to the craving that an alcoholic will experience upon having the first sip of alcohol. Describe your idea of a perfect breakfast, lunch and dinner Let’s just say they are meals that include plenty of fat, some protein and no starches, sugars or grains. Breakfast for me lately has been salmon and an avocado. Lunch and dinner are variations of fish, meat or fowl with green vegetables, usually cooked with plenty of butter. I like to say that my copious research has led me to believe that bacon and butter are good for me. I hope the heck I’m right. Do you think sugar is the new tobacco in the industry? Yes, I think this is true in the sense that sugar has very likely led to more premature deaths than tobacco. And I can say this with confidence because of the vital role that the high sugar content of tobacco leaves plays in cigarettes. It’s a fascinating story and one I tell in my book. On the other hand, I don’t think the sugar industry was nearly as evil as the tobacco industry and it remains to be seen whether they will get there in service to the bottom line. The sugar industry and the beverage industry folks really believed they were giving the world a wonderfully healthy and delightful product — the pause that refreshes, as Coca Cola memorably put it — and the nutritionists, obesity and diabetes researchers more or less agreed. So for a century the nutrition and obesity researchers were the sugar industry’s best allies. It’s only in the last ten years, thanks to the work of Rob Lustig at UC San Francisco and others, that we’ve once again started to think about sugar as more than just empty calories that we eat in excess and something that is perhaps, quite literally toxic. Although toxic over years to decades, not in the short term. Now the sugar industry has a very different argument to confront and the nutritionists, obesity and diabetes specialists, more and more, are not their allies. We’ll see what happens. Read more about it in The Case Against Sugar. CREDIT: Portobello Books, published 4 January 2018 | paperback | £9.99 The Case Against Sugar has also been shortlisted for the André Simon Food & Drink Book Awards. Founded in 1978, the André Simon Food & Drink Book Awards are the only awards in the UK to exclusively recognise the achievements of food and drink writers and are the longest continuous running awards of their kind. The first two awards were given to Elizabeth David and Rosemary Hume for their outstanding contribution in the fields of food and cooking. Other winners include Michel Roux, Hugh Fearnley-Whittingstall, Nigel Slater and Rick Stein.