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Attia: If You Want Better Answers, Ask Better Questions
The wrong question is being asked. “Is sugar toxic?” is a silly question. Why? Because it lacks context. Is water toxic? Is oxygen toxic? These are equally silly questions, I hope you’ll appreciate. Both oxygen and water are essential for life (sugar, by the way, is not). But both oxygen and water are toxic – yes, lethal – at high enough doses.
What did the APAP example teach us? For starters, don’t confuse acute toxicity with chronic toxicity. Let’s posit that no one has died from acute toxicity due to massive sugar ingestion. But, what about chronic toxicity? Can eating a lot of sugar, over a long enough period of time, kill you (presumably, through a metabolic disease like diabetes, Alzheimer’s disease, cancer, or heart disease)?
Even among a healthy population (i.e., people without overt liver disease), toxicity is a distribution function. What’s toxic to one person may not be toxic to the next. This is true of APAP and it’s true of sugar. It’s true of most things I can think of, actually, including tobacco, alcohol, cocaine, and heroin. Ever wonder why “only” about one in six smokers dies of small cell lung cancer? Maybe it’s the same reason some people (e.g., me) get metabolically deranged from even modest doses of sugar, while others (e.g., Jill, my wife) can mainline the stuff and not appear to suffer many adverse effects.
I posit that Jill and I are both outliers on the distribution of susceptibility, probably driven mostly by genetic difference (rather than, say, exercise as we both exercise a lot). So, I offer you a framework to consider this question. I know some of you just want an answer to the question, Is sugar toxic or not? But I hope this slightly more nuanced response can help you figure out what you should be asking: Are you like me? Like Jill? Or like an Average Joe somewhere in between us?
In Attia style, he examines the snot out of this issue, covering terms, concepts and research on the topic. If you read the whole post, you'll be smarter or at least feel like you are. I like his conclusion - if your body is healthy, you feel great, and life is too good to be true, the dose of sugar you are on is likely not toxic. If you are hungry, carry too much fat, have a nasty lipid profile (and/or gout, hypertension, or high pain levels), you are probably eating too much sugar. As Taubes describes in "Good Calories Bad Calories", we were relatively healthy when average annual consumption of sugar was 20 pounds per capita - that was back in the days when sugar was costly and a treat vice a staple of the US/Western diet. Now, at 100 pounds annually or more, many of us are ingesting toxic levels of sugar.