I’ll say something heretical: a little refined sugar is not that bad.
Nowadays, sugar has been labeled public enemy #1, and to say otherwise might appear to be completely crazy.
No one ever said that refined sugar is a health food. But the fact is:
- Sugar alone did not cause the obesity epidemic in the Western world.
- Sugar alone does not cause heart disease.
- Sugar alone does not cause diabetes.
- A healthy person on a healthy diet can eat some refined sugar (i.e. white sugar) without any negative consequences.
- One of the most radical diets ever conceived to treat hypertension before the advent of drugs, the rice diet, included lots of white sugar. This diet was used successfully to treat obesity and heart disease as well.
Let’s now dig a little deeper:
One therapeutic example of a diet as low in fat as one can imagine is the Rice Diet, designed by German refugee Walter Kempner in the 1940’s, as a radical treatment for malignant hypertension, before the advent of drugs.
Not only did the Rice Diet cure most cases of severe hypertension, but it also worked to relieve headaches, fatigue, and heart disease. It also cured several cases of Type 2 diabetes.
The typical composition of the rice diet contained 565 grams of carbohydrates, from fruit, white rice, and white sugar. It contained only 25 grams of protein and 5 grams of fat. So the Rice Diet contained less than 2% of calories from fat!
The presence of sugar can baffle modern dieters, but it was added to increase the calories without adding any vegetables or other foods which might contain sodium. On average, patients consumed 400 calories a day from white sugar. They added a few vitamin supplements. The sodium content was only 150 mg/day.
As a therapy, not a diet choice, this diet was incredibly successful! (McDougall tells the full story here. Given its success, this documented part of medical history shows that our obsession on nutritional deficiencies (protein, sodium, calcium, and fat) must be misguided.
Not All Sugar Is Created Equal
White sugar is not a healthy food, but it’s also not a drug, and it’s often just a scapegoat for diseases it has less to do with than we think
The same goes for all forms of refined sugar: maple syrup, honey, high-fructose corn syrup, etc.
There’s a lot of confusion in the realm of nutrition because we hear two contradictory statements. On the one hand, we are told to eat more plant foods. On the other hand, we are told to eat less sugar, including less starch or “carbs.”
However, by default, plant foods ARE high-carb foods. The vast majority of edible plants that have been cultivated by humans are high in natural sugar or starch. Low-sugar vegetables are nutritious, but they can’t sustain a human being because they do not contain much energy.
A few plant foods are high in fat instead of high in sugar: avocados, nuts, seeds, coconuts. But those foods are the exception, not the rule. In a natural setting, they were only found seasonally and in very specific geographic locations.
The reason we have this contradiction is because popular diet “experts” all claim that a healthy diet is one loaded with “good fats.”
They want you to eat a diet full of salmon, sardines, olive oil, nuts, seeds, chicken, lamb and grass-fed beef. Eat lots of “good fats,” minimize the carbs, eat lots of veggies. That is, more or less, the advice of 95% of diet books.
However, when we look at healthy populations around the world that have experienced superb levels of health, such as NO heart disease, no diabetes, and no breast or prostate cancer, we find that they have one thing in common: they do not eat plenty of “good fats.” Quite the opposite, they eat a plant-based diet that emphasizes natural sugar or starch.
For example, the Tarahumara Indians of Northern Mexico ate a diet consisting almost entirely of starch and vegetables, and they experienced almost no heart diseases or cancer. They were the most amazing endurance runners the world has ever known as well.
Some native populations of New Guinea ate a diet composed almost exclusively of sweet potato. It contained only 7% protein and less than 10% fat. Autopsies were done on 600 of those natives in the 1960s and only ONE mild case of heart disease was detected! The same autopsies done here would have revealed that almost every single American has heart disease.
White Sugar: the Modern Drug?
In an article published in the Huffington Post, a Dutch health official was quoted as saying that “sugar is the most dangerous drug of our time.”
“Paul van der Velpen, head of Amsterdam’s health service, suggests that food and drink with high-sugar content should come with health warnings. He suggests introducing hard-hitting campaigns similar to the anti-smoking messages found on cigarette packets.”
Such anti-sugar statements, meant to scare away the public, have been popular ever since the book Sugar Buster was published in 1995.
Granted, sugar contains empty calories. Eat a lot of it on a regular basis and you’ll harm your health in more than one way.
But comparing sugar to a drug like cocaine or even tobacco is totally inappropriate. Anyone who has given up tobacco or other truly addictive drugs can certainly attest to that. Nobody has ever stolen a car stereo to get a Mars bar!
The desire for sugar is hardwired inside of us, as opposed to the desire for nicotine, caffeine, heroin, and other drugs. The body actually requires glucose — the main type of sugar found in white sugar — in order to function.
The reward centers of the brain are activated when sugar is consumed. Because the reward centers of the brain are also activated when cocaine and heroin are consumed, our health advocates have taken this leap in imagination to call sugar “just as bad as cocaine.”
The truth is that sugar, in itself, isn’t bad. The body requires it in one form or another. Most foods we consume on a daily basis contain some sugar, either in a complex form or a simple form (as in fruit). And if the food is healthy it will also contain fiber, vitamins, and minerals alongside protein and perhaps some fat.
It’s Very Difficult to Get Fat with Sugar Alone
People like to blame the obesity crisis in the United States to sugar and sugar alone, as well as other forms of carbohydrates.
But let’s take a look at some data to make up our minds.
The tables above show changes in carbohydrate, protein, and fat intake from 1990 until 2008. And then calorie intake, as well as the result on BMI (body mass index).
What we can see is that Americans today consume 49% of their calories from carbohydrates. That number is actually DOWN since 1990, when the number was 52%.
Actually, in every other country represented, carbohydrate consumption is down since 1990.
On the other hand, protein consumption is stable in ALL countries. One difference is that fat consumption is up, and most importantly, total calories are up.
The BMI evaluates the weight of an individual versus the height, and is a good indicator of a healthy weight, especially for populations at large. In all countries, people have gotten fatter.
Americans were overweight in 1990, and they are still overweight today, only more so. But as we look at three countries, we find that the more carbohydrates are consumed, the slimmer the population is. Americans consume the fewest carbohydrates and are the fattest. Thai people consume the most carbohydrates by calories and are the slimmest. Of course, they consume fewer calories in general.
We could play with numbers all we wanted, but the bottom line is that carbohydrates, in general, DON’T make people fat. The real culprit is caloric intake.
Now someone could say that sugar intake is up since 1990, and could blame obesity on this. But the truth is that ALL food intake is up. Calories are up. Fat intake is up. Carbohydrate intake is up, not by percentage of calories, but in actual grams consumed.
Do People Consume Sugar Alone?
We tend to look at certain sugary junk foods as “sugary sweets” — things like ice cream and chocolate bars. But in fact, the majority of calories in those foods come from fat, NOT sugar.
Is Sugar Really Turned Into Fat?
One of the biggest claims made about sugar (especially high-fructose corn syrup) is that it’s turned into fat in the body.
In other words: eating sugar will make you fat.
This process is known in science as de novo lipogenesis, or the production of new fat from other caloric sources (namely carbohydrates).
Some animals, such as cows, have a physiology that makes it very easy for them to convert carbohydrates into fat for long-term storage. For example, cows eat grass, which is a carbohydrate that’s indigestible for humans (but they have the ability to use the energy in it), and cows can store an incredible amount of fat from this food source.
Humans are very inefficient at converting sugar into fat.
In a lecture on Fructose, Sucrose and High-Fructose Corn Syrup (HFCS), Dr. James M. Rippe presented the current research on the subject. A few highlights:
- Americans consume between 100 and 150 grams of fat a day. How much of body fat is generated from their sugar or carbohydrate intake? About one gram!
- In one study, they gave young healthy males up to 50% added carbohydrates. That’s 1500 calories above their regular diet! How much fat was produced by their bodies on this excess? 3.3 grams on average. That’s on a diet containing over 700 grams of carbohydrates.
- To put it in perspective, one pound of fat is 450 grams.
So when you feed people an extra 1500 calories from sugar or carbohydrates, and about 3 grams of extra fat are generated by the body, where is the rest going?
Essentially, to glucose.
You can make somebody fat by feeding them extra sugar and carbohydrates, but it’s NOT because it’s turned into fat. It’s because it’s preventing the fat in the diet to be turned into energy, which is called the oxidation of fatty acids.
In other words, here’s what happens:
1) People eat sugar
2) They eat other forms of carbohydrates
3) The average American eats between 100 and 150 grams of fat in their diet
4) The carbohydrates they eat are turned into energy. Only one gram on average is turned into fat.
5) The body STORES the extra calories coming from fat into body fat, instead of burning them off as energy.
Whenever there’s an imbalance in energy (too many calories in, not enough calories out), the body will store excess calories as fat. But those calories essentially come from the fat in your diet, not the carbohydrates!
That’s why high-carbohydrates, low-fat (less than 10% of calories) programs are still effective ways of losing weight. I saw it with my own eyes when I put my own mother on such a diet, and she lost over 60 pounds without ever gaining it back.
Low-carbohydrate, low-sugar diets are also effective, but that’s because they increase protein — decreasing total caloric intake. So the equation still works: fewer calories in than out.
It’s true that fructose increases fat production more than sucrose, in terms of percentage. But when we look at actual grams of fat produced by the body, it’s not a significant difference and certainly not a health threat (in a balanced diet that doesn’t contain much refined sugar).
Fatty Liver Disease
A lot of misinformation has been circulating in health circles lately about fructose. Namely, that consuming fructose from refined or even natural sources can cause fatty liver disease.
In one study quoted by Dr. Rippe, a group of more than 300 people were consuming 8, 18 or 30% of their calories as HFCS or sucrose. There was no increase in fatty liver at the end of the study in either group.
Sugar and Diabetes
Sugar causes diabetes, right?
It turns out that the truth is more complicated. As we’ve seen, countries in the world with the highest carbohydrate intake appear to be the slimmest.
In the United States, the incidence of diabetes mellitus is 12.3% of the population.
In Thailand: 7.70%
In Japan: 7.30%.
Rural Africa and Asia (as opposed to the urban populations of Japan and Thailand) have some of the lowest rates worldwide of diabetes. They traditionally consume a diet that is very rich in carbohydrates, even by our standards.
The highest rates of diabetes are found among Hispanic, Polynesian and African-descent people who adopt an American-like diet and lifestyle.
Research actually shows that:
A high-carbohydrate diet actually makes the body’s insulin work more efficiently.
In one study, researchers took carbohydrate consumption from 45% to 85%. Researchers concluded:
“Fasting plasma glucose levels fell in all subjects and oral glucose tolerance (0 to 120-minute area) significantly improved after 10 days of high carbohydrate feeding. Fasting insulin levels also were lower on the high carbohydrate diet. These data suggest that the high carbohydrate diet increased the sensitivity of peripheral tissues to insulin.” (Reference)
In a more recent study, this time in Northern Ireland, researchers looked at the effects of high sugar intake on insulin resistance in non-diabetic men. The group receiving 25% of their calories from sugar (sucrose) as part of a diet otherwise balanced and containing adequate calories saw no difference in their degree of insulin resistance during the 6-week period, compared to the group getting 10% of their calories from sugar.
“Sugar has traditionally been linked to the development of diabetes. These findings challenge that thinking, and show that intakes of more than double that currently recommended do not appear to have an adverse effect on markers of diabetes risk.”
So if a high carbohydrate or even high sugar intake does not cause diabetes, what causes it?
It seems clear that excess calories and a sedentary lifestyle, leading to excess body fat, along with genetic factors, are the main causes. Other factors such as excessive drinking and tobacco use are also at play.
High-fat diets DO lower insulin sensitivity, so when high fat intake is combined with high sugar intake, along with excess calories in general, you have a recipe for disaster.
People on low-carbohydrates, higher-fat, higher-protein diets don’t typically develop diabetes because they are keeping their caloric intake under control. Even though this type of diet will make insulin less efficient, as long as total calories are kept in check, you can see miracles happen.
But the reverse is also true. Programs like the Fuhrman “Eat to Live” diet, Dr. Esselstyn’s plan, Dr. Neal Barnard, Dr. McDougall and others all promote a high-carbohydrate, low-fat diet to prevent and reverse type 2 diabetes.
I’ve communicated with type 1 diabetics who went on Doug Graham’s 80-10-10 diet, consumed insane quantities of fruit sugar (often a lot of dates) and managed to dramatically lower their insulin needs on that diet.
To prevent type 2 diabetes or even reverse it, many experts recommend staying active, lowering your body fat to a healthy and even level, keeping total calories in check, and eating a whole food diet as the best way to go. In their experience, lowering fat consumption and increasing carbohydrates from whole sources, even with lots of fruit, can give great results.
Dr. Fuhrman’s approach to diabetes involves reducing fruit intake and refined carbohydrate (including white potato and white sugar), making beans and low-glycemic starchy foods the main source of carbohydrates in one’s diet.
Sugar and Athletes
One thing is for sure: consuming too much fructose, especially from refined sources, is not desirable for the sedentary individual. However, during fitness activities, fructose seems to be the greatest thing ever. Gretchen Reynolds writes in her wonderfully well-researched book The First 20 Minutes: Surprising Science Reveals How We Can: Exercise Better, Train Smarter, Live Longer:
“In general, fructose seems desirable for athletes. When cyclists in one large study downed a sports drink sweetened only with glucose during a two-hour bout of moderate pedaling, they rode faster during a subsequent time trial than riders who had drunk only water. But if the sports drink contained both glucose and fructose (in a two-to-one ratio), the riders were 8% faster in the time trial than those drinking glucose-sweetened fluids alone.”
How Much Sugar is Safe to Eat?
White sugar is not a health food. But it’s also not the great evil it’s painted out to be. Granted, eat a lot of white sugar on top of a high-calorie diet and you’ll gain weight. You’ll ruin your teeth and experience all kinds of problems.
But a little refined sugar here and there is not going to hurt, when you keep things in perspective.
People eat out at a Thai restaurant and worry about the 1 teaspoon or two of sugar that was used in their Pad Thai, not really thinking about the multiple tablespoons of vegetable oil used to stir-fry the whole thing! The sugar amounts to maybe 30-40 calories, while the oil gives at least 300-400.
When you think about all the junk food that most people crave (chocolate comes to mind), those foods are primarily high in fat.
Some people drink colas all day to get their sugar high, but if it were not for the presence of caffeine in those drinks, they would likely be much less addicted.
Overall, you probably shouldn’t consume more than 100 to 150 calories a day from refined sugar. The fewer, the better. One tablespoon of white sugar or syrup (like honey or maple syrup) is around 50 calories.
But if you’re active and at a healthy weight, a little sugar is not going to harm you. It may even help your performance and your recovery, although getting it from whole food sources is always better.
I’m personally more worried about hidden fat than hidden sugar. Don’t worry about the little sugar that’s found in your sushi rice. Worry about the generous quantities of mayo used in the roll instead!
There’s only so much sugar we can eat before feeling that it’s nauseatingly over-sweet. But hidden fat can be added to almost no end.
From the article I wrote on the book Salt, Sugar, Fat:
“Food manufacturers had known for a long time that the bliss point of sugar was fixed: it was a specific point of pleasure, and a strict limit at the same time for the sugar content of any food. But for fat, it seems there was no ‘break point.’ No matter how rich the food was, people never got the signal that there was simply ‘too much fat.’ The body just wants more and more fat. One researcher said ‘if there was a break point, it was somewhere beyond heavy cream.”
I personally eat a lot of fruit, so I don’t crave refined sugar very much. But I don’t mind eating something (artificially) sweet once in a while with absolutely no adverse effects.
Some people are more sensitive to sugar intake, reporting “blood sugar swings” whenever they eat something sweet and often experiencing the effects of low insulin sensitivity. A high-fat diet is often a hidden cause of lowered insulin sensitivity.
My goal in this article was not to convince you to eat refined sugar, but rather to demystify the topic and also redeem the important role of carbohydrates in the diet. Carbohydrates have been blamed for the obesity epidemic, when in fact the slimmest nations in the world eat a high-carbohydrate diet.
Body Mass Index by Country: http://chartsbin.com/view/577
Global Nutrition and BMI: http://chartsbin.com/view/1162
Sugar, Coated with Myths – http://www.drmcdougall.com/misc/2006nl/sept/sugar.htm
Sugar is an addictive drug? http://scienceblogs.com/purepedantry/2008/12/11/sugar-is-an-addictive-drug-ehs/
Now Sugar is Addictive: http://scepticalnutritionist.com.au/?p=199
Carbohydrates, fat, and insulin action. http://www.ncbi.nlm.nih.gov/pubmed/8116551
Sugar not linked to diabetes http://www.medicalnewstoday.com/releases/59111.php
Symposium: Fructose, Sucrose and HFCS (Search on YouTube)
Nathan Pritikin, “High Carbohydrate Diets: Maligned and Misunderstood“.
Frequently Asked Questions on Dr. Essesstyn Approach to Treating Heart Disease
Summary of Research by Dr. Dean Ornish.
Denise Minger, “In Defense of Low Fat“:
Study: Some Biochemical Effects of a Mainly Fruit Diet in Man
Dr. Greger’s Research Summary on fruit.
Dr. John McDougall, “How I Treat Diabetes” and The Starch Solution Presentation.