If you have been following the saga of my attempts to have comments posted at the Huffington Post, I have an update.
Dr Robert Lustig recently published an article in Nature in which he argued that we need to take drastic measures to reduce the consumption of sugar. His is a well-reasoned argument based on evidence that sugar, and the fructose component in particular, is uniquely harmful. Remember that all sugar is 50% fructose and 50% glucose. High Fructose Corn Syrup (HFCS) tends to have a bit more fructose because this is the molecule that delivers the most sweetness. HFCS is typically 55% fructose and 45% glucose. In terms of effect, both sugar and HFCS are the major sources of fructose in our diet and have been increasing in consumption over the decades during which we have been experiencing the twin epidemics of obesity and type 2 diabetes. There is physiological evidence that fructose consumption can be implicated in a number of conditions including insulin resistance, fatty liver, gout and hypertension. Lustig’s article has generated the predictable backlash from the vested interests in the agri-food sector whose bottom lines would be severely affected if people stopped eating all the useless crap they produce and which fills the centre aisles of the supermarket.
Meanwhile, over at HuffPo, Dr David Katz has weighed in with an article entitled, “Sugar, On a Slippery Slope” (http://www.huffingtonpost.com/david-katz-md/sugar-regulation_b_1255695.html), where his basic argument is that the poison is in the dose. He says that it isn’t sugar per se that is a problem but rather that people eat too many calories of which some are sugar. He goes on to vilify diets that exclude the “nutrients du jour”, an obvious dig at low-carb diets.
Here are his own words:
There is no question that excess sugar is one of the great liabilities of the modern diet, and consequently, one of the great liabilities of public health. Excess sugar intake is implicated in everything from obesity to diabetes to coronary artery disease. Because excess consumption of sugar induces hormonal imbalances — notably high levels of insulin — which in turn foster inflammation, excess sugar intake is linked to cancer risk as well. Finding effective ways to reduce ambient sugar intake is not only warranted, but rather urgent — as we confront epidemics of obesity, diabetes and associated chronic diseases.
Wow! That’s pretty damning. I guess he is on our side after all. How can you not be in favour of harsh measures to constrain the consumption of something so obviously toxic to the human body?
Regulating nutrients, per se, is a slippery slope. If we regulate sugar, we should certainly regulate trans fat — which is far less important to palatability, and more toxic in smaller quantities.
And if so, what about the real culprit in much of what most ails modern public health: calories? The root cause of most diabetes and much other chronic disease is obesity, and the most indelible link between weight and food is not composition, but quantity. If sugar is poison because of the harms of excess, so too — and then some! — for calories. Shall we regulate the quantity of food people eat?
This is a classic reductio ad absurdum argument. In addition, it is based on the faulty studies that tested low-carb diets against other macronutrient variations which concluded that they all delivered the same benefit, or rather, lack of benefit (I will post another discussion on some recent examples of this soon).
We have decades of dietary debacles to show we are unlikely to get to health one nutrient at a time. It is past time to start thinking about the overall nutritional quality of foods, and diet — which are what truly matter to health outcomes. Sugar is an important component of this, to be sure — but only a component.
And he concludes with this:
We eat too much sugar; doing so conspires against our health, and needs to change. The ends are clear, the best means are less so. I worry that some good intentions could bog us down in conflict that forestalls all progress, distort the relative importance of just one nutrient relative to overall nutrition, and land us on a slippery slope headed toward unintended consequences. The sweet spot will be defined by what works in the real world to improve the quality of prevailing diets, and health.
Now, when I first read this, it immediately occurred to me that the whole piece could have been written by the PR people at Coca-Cola. It so nicely dovetails with the kind of smokescreen they and other sugar-dependent companies send up whenever some science has shed light on the harms of their principle ingredient and profit centre. It’s all very reminiscent of the tactics used by the tobacco industry when their products first came under attack.
In the past, I have had my differences with Dr Katz and have been frustrated at times when my reasoned but pointed comments on his articles are censored (see Ornish Filter posts below). It has always struck me as odd, however, that a fellow MD, knowledgeable about nutrition and chronic disease, Director, no less, of the Yale Prevention Research Center, could be so stubbornly averse to acknowledging the now obvious benefits of dietary carbohydrate restriction. Well today, I think I got my answer. Here is a comment from TinaFxyz that did make it past the censors:
One has to question Dr. Katz’s motives. His “Turn The Tide” foundation
He supports the convention
What he is saying is that candy, soft drinks, fruit juice, refined grains, and other processed and carbo-load
All of those companies listed above are sponsors for his research groups and various business activities – I found all of this informatio
Kaboom! Well, there it is for all to see. Is this guy going to take a public position that is fundamentally against the interests of the corporations that fund his work?
There is a well known concept in the business and academic world known as “conflict of interest”. There is also a lesser known concept in the philosophy of art world known as “corruption of consciousness”. I think they both have relevance here.
I wonder how long TinaFxyz will continue to have her comments published on HuffPo.