HFCS is not Equal to Table Sugar

A Princeton University research team has demonstrated that all sweeteners are not equal when it comes to weight gain: Rats with access to high-fructose corn syrup gained significantly more weight than those with access to table sugar, even when their overall caloric intake was the same.  

In addition to causing significant weight gain in lab animals, long-term consumption of high-fructose corn syrup also led to abnormal increases in body fat, especially in the abdomen, and a rise in circulating blood fats called triglycerides. The researchers say the work sheds light on the factors contributing to obesity trends in the United States.

"Some people have claimed that high-fructose corn syrup is no different than other sweeteners when it comes to weight gain and obesity, but our results make it clear that this just isn't true, at least under the conditions of our tests," said psychology professor Bart Hoebel, who specializes in the neuroscience of appetite, weight and sugar addiction. "When rats are drinking high-fructose corn syrup at levels well below those in soda pop, they're becoming obese -- every single one, across the board. Even when rats are fed a high-fat diet, you don't see this; they don't all gain extra weight."

http://www.princeton.edu/main/news/archive/S26/91/22K07/

This is interesting research which is counter intuitive has interesting long term implications for business, government and consumers.  All it means to us is that when we say "no sugar, no wheat" it's because that's what works.

Bittman's Great Summary

This one was so compelling, I'm reposting it.  It is foundational material in my book.

"The study controlled for poverty, urbanization, aging, obesity and physical activity. It controlled for other foods and total calories. In short, it controlled for everything controllable, and it satisfied the longstanding "Bradford Hill" criteria for what's called medical inference of causation by linking dose (the more sugar that's available, the more occurrences of diabetes); duration (if sugar is available longer, the prevalence of diabetes increases); directionality (not only does diabetes increase with more sugar, it decreases with less sugar); and precedence (diabetics don't start consuming more sugar; people who consume more sugar are more likely to become diabetics).

The key point in the article is this: "Each 150 kilocalories/person/day increase in total calorie availability related to a 0.1 percent rise in diabetes prevalence (not significant), whereas a 150 kilocalories/person/day rise in sugar availability (one 12-ounce can of soft drink) was associated with a 1.1 percent rise in diabetes prevalence." Thus: for every 12 ounces of sugar-sweetened beverage introduced per person per day into a country's food system, the rate of diabetes goes up 1 percent. (The study found no significant difference in results between those countries that rely more heavily on high-fructose corn syrup and those that rely primarily on cane sugar.)"

http://opinionator.blogs.nytimes.com/2013/02/27/its-the-sugar-folks/?_php=true&_type=blogs&_r=0

This article references a study (linking in the article) that is about as good as it gets in health science. Bittman's summary is spot on - until he gets to his politics, which I could do without.  Coercion hasn't worked well at all with regards to food and health.  I say let's try cooperation.

The Sugar-Addiction Taboo - Robert H. Lustig - The Atlantic

"No one argues that food isn't pleasurable, or even that food doesn't activate the "reward center" of the brain. But can food truly be addictive? In the same way that alcohol, tobacco, and street drugs are?"

In the article linked here, 

http://www.theatlantic.com/health/archive/2014/01/the-sugar-addiction-taboo/282699/
Robert Lustig makes the case that sugar addiction is just as real as any other.  I agree.  There's a simple model I wrote about some time back (this is it), and while it's neither proved or under research, the concepts he relates in this article point to similar pathways for sugar addiction.

The BLUF - without sugar, food does not pervert our basic drive to consume the nutrition we need.  With sugar, we behave like addicts.  My two favorite paragraphs follow:

"Which brings us to sugar. Another fun substance, full of energy, made up of two molecules linked together: glucose (kind of sweet, and not that much fun), and fructose (very sweet, and a whole lot of fun). Glucose is a nutrient, although not essential—it's so important, that if you don't eat it, your liver will make it. But what about fructose? Is fructose a nutrient? As it turns out, there's no biochemical reaction that requires dietary fructose. A rare genetic disease called Hereditary Fructose Intolerance afflicts 1 in 100,000 babies, who drop their blood sugar to almost zero and have a seizure upon their first exposure to juice from a bottle at age six months. Doctors perform a liver biopsy to confirm the diagnosis. From that moment on, they're fructose-free for the rest of their lives. And they're among the healthiest people on the planet. Alcohol and fructose both supply energy. They're fun—but they are not nutrients."

"But oh, do we want it. As an example, rats are not big fans of lard. But if you lace the lard with some sugar (called "cookie dough"), that's another story — indeed, in a controversial abstract at this year's Society for Neuroscience meeting, rats were found to prefer Oreos to cocaine. And we humans are not far behind. A recent study by Dr. Eric Stice of Oregon Health Sciences University looked at our obsession, by parsing out the fat from the sugar. Subjects laying in an MRI scanner consumed milkshakes where the fat and the sugar concentrations were dialed up or down.  Bottom line, fat stimulated the somatosensory cortex (in other words, "mouthfeel"), but only sugar stimulated the reward center. And adding fat to the sugar didn't increase the reward any further. This study shows we want sugar way more than we want fat."

Lustig's hot for government action, but of course, government action has been the sugar industry's best friend for a long time.  I'd prefer the government just stayed out of our food, so that government cannot be highjacked but the highest bidders.

But for you and for me the message is simple.  Alcohol, sugar, driving, shooting guns, swimming pools, motorcycles - high risk, handle with care.

Mice and Sugar, What Could Be Better?

For the rodents on the sweetened diet, sugar accounted for 25 percent of their total calorie intake. Up to a quarter of Americans consume that proportion of sugar as part of their diets. Previous studies that found harmful effects of sugar consumption tended to use unusually high amounts.

“[Our findings] set a new standard for caution even at low doses of added sugar,” senior author and biologist Wayne K. Potts said.

About 80 percent of substances that are toxic in mice are toxic for people as well, said Potts, so it is likely that the effects of extra sugar could be similar in humans.

The researchers first fed 156 animals either sweetened or normal diets for 26 weeks. They then used a novel lab setup: room-sized mouse barns where the animals could roam free instead of being confined in cages. The goal was to mimic the natural environment.

http://www.washingtonpost.com/national/health-science/study-sugar-even-at-moderate-levels-toxic-to-mice-health-reproduction/2013/08/13/95887bee-0443-11e3-a07f-49ddc7417125_story.html

For me this is a pretty good example of confirmation bias - since I'm already a believer that sugar will kill you (at a toxic dose, it will, although the amount that makes sugar toxic is not not known for sure).  But you have to ask yourself - if sugary food can kill mice in just 26 weeks, who could possibly argue with science?

It is interesting to see the flurry of furry mice being exposed to sugar now, vice fat, since hating fat has become slightly passé.

Pure White and Deadly, Revisited

John Yudkin published this book (http://www.amazon.com/Pure-White-Deadly-Sugar-Killing/dp/0143125184/ref=sr_1_1?s=books&ie=UTF8&qid=1390226626&sr=1-1&keywords=pure+white+and+deadly) in the 1970s, and was ridiculed by his learned peers.  It's taken the science from then to now to catch up.  But as these studies are demonstrating, he was right. The toxicity level of sugar is very, very low and the health impact is catastrophic.

Background

Refined sugars (e.g., sucrose, fructose) were absent in the diet of most people until very recently in human history. Today overconsumption of diets rich in sugars contributes together with other factors to drive the current obesity epidemic. Overconsumption of sugar-dense foods or beverages is initially motivated by the pleasure of sweet taste and is often compared to drug addiction. Though there are many biological commonalities between sweetened diets and drugs of abuse, the addictive potential of the former relative to the latter is currently unknown.

Methodology/Principal findings

Here we report that when rats were allowed to choose mutually-exclusively between water sweetened with saccharin–an intense calorie-free sweetener–and intravenous cocaine–a highly addictive and harmful substance–the large majority of animals (94%) preferred the sweet taste of saccharin. The preference for saccharin was not attributable to its unnatural ability to induce sweetness without calories because the same preference was also observed with sucrose, a natural sugar. Finally, the preference for saccharin was not surmountable by increasing doses of cocaine and was observed despite either cocaine intoxication, sensitization or intake escalation–the latter being a hallmark of drug addiction.

Conclusions

Our findings clearly demonstrate that intense sweetness can surpass cocaine reward, even in drug-sensitized and -addicted individuals. We speculate that the addictive potential of intense sweetness results from an inborn hypersensitivity to sweet tastants. In most mammals, including rats and humans, sweet receptors evolved in ancestral environments poor in sugars and are thus not adapted to high concentrations of sweet tastants. The supranormal stimulation of these receptors by sugar-rich diets, such as those now widely available in modern societies, would generate a supranormal reward signal in the brain, with the potential to override self-control mechanisms and thus to lead to addiction.

http://www.plosone.org/article/info:doi/10.1371/journal.pone.0000698

While experimental and observational studies suggest that sugar intake is associated with the development of type 2 diabetes, independent of its role in obesity, it is unclear whether alterations in sugar intake can account for differences in diabetes prevalence among overall populations. Using econometric models of repeated cross-sectional data on diabetes and nutritional components of food from 175 countries, we found that every 150 kcal/person/day increase in sugar availability (about one can of soda/day) was associated with increased diabetes prevalence by 1.1% (p <0 .001="" a="" activity="" after="" aging="" alcohol="" and="" are="" as="" associations="" at="" availability="" behavior="" biases="" but="" by="" calories="" cereals="" changes.="" confounded="" confounders.="" controlling="" correlated="" declines="" degree="" diabetes="" dietary="" differences="" dose-dependent="" duration="" effect="" explain="" explained="" exposure="" fibers="" food="" for="" fruits="" impact="" in="" including="" income.="" independent="" independently="" individual="" level="" manner="" meats="" modified="" no="" not="" obesity.="" obesity="" of="" oils="" on="" or="" other="" overweight.="" overweight="" period-effects="" physical="" population="" potential="" prevalence="" rates="" sedentary="" selection="" several="" significant="" significantly="" socioeconomic="" span="" statistically="" subsequent="" such="" sugar="" testing="" that="" the="" total="" types="" urbanization="" use="" variables="" variations="" was="" while="" with="" yielded="">
http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0057873

How Did Smoothies Gain the Mantle of "Healthy"?

"Think of eating one orange or two and getting filled," he said. "Now think of drinking a smoothie with six oranges and two hours later it does not affect how much you eat. The entire literature shows that we feel full from drinking beverages like smoothies but it does not affect our overall food intake, whereas eating an orange does. So pulped-up smoothies do nothing good for us but do give us the same amount of sugar as four to six oranges or a large coke. It is deceiving."

Nine years ago the two scientists had identified sugar-sweetened soft drinks, full of calories and consumed between meals, as a major cause of soaring obesity in developed countries. But they argue that as people change their drinking habits to avoid carbonated soft drinks, the potential damage from naturally occurring fructose in fruit juices and smoothies is being overlooked.

All sugars are equal in their bad effects, says Popkin – even those described on cereal snack bars sold in health food shops as containing "completely natural" sweeteners. "The most important issue about added sugar is that everybody thinks it's cane sugar or maybe beet sugar or HFC syrup or all the other syrups but globally the cheapest thing on the market almost is fruit juice concentrate coming out of China. It has created an overwhelming supply of apple juice concentrate. It is being used everywhere and it also gets around the sugar quotas that lots of countries have."

http://www.theguardian.com/society/2013/sep/07/smoothies-fruit-juices-new-health-risk

There's not much to this article except the obvious and the irony.  The obvious is that you can dress sugar up and call it a smoothy or a Gift from God or "Pure and Natural" but it still is harmful above a certain threshold (safe intake is likely ~20g/day?).  
The irony is the industry is using George Bray's longstanding argument that a "calorie is a calorie" against him:

"Coca-Cola argues ... "We believe that rather than single out any ingredient, it is more helpful for people to look at their total energy balance. This is because obesity and weight gain are caused by an imbalance in calories consumed and burnt off. Our products should be enjoyed as part of a sensible, balanced diet and healthy lifestyle that includes regular physical activity.

"For those that are watching their calorie intake, we offer a wide range of low or no calorie options, which represent more than one third of our sales.""

It is obviously possible to make a healthy smoothy, but sadly many associate the term with "healthy" when instead they are getting just another sugar bomb in sheep's clothing.

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?

http://eatingacademy.com/nutrition/is-sugar-toxic

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.  

Nat Geo, Slavery, Sugar, and Why We Got Fat

This is the money line, which is a restatement of the theorem well articulated by Gary Taubes in "Good Calories, Bad Calories":
"Johnson summed up the conventional wisdom this way: Americans are fat because they eat too much and exercise too little.  But they eat too much and exercise too little because they're addicted to sugar, which not only makes them fatter but, after the initial sugar rush, also saps their energy, beaching them on the couch." The reason you are watching TV is not because TV is so good," he said, "but because you have no energy to exercise, because you're eating too much sugar."
http://ngm.nationalgeographic.com/2013/08/sugar/cohen-text

Head Scratcher

It's a head scratcher that an organization like this - the health newsletter of Harvard - is lazily recommending actions that are ten years out of date.  Even the institution's own scientists have moved past the "lowfat to lower cholesterol" fad and back towards science.

The emailed newsletter starts:
"People can reduce cholesterol levels simply by changing what they eat. For example, if you are a fan of cheeseburgers, eating less meat (and leaner cuts) and more vegetables, fruits, and whole grains can lower your total cholesterol by 25% or more. Cutting back on saturated fat (found in meat and dairy products) and trans fat (partially hydrogenated oils) can reduce cholesterol by 5% to 10%."

They recommend these four things to "lower your cholesterol":
"Stick with unsaturated fats and avoid saturated and trans fats.  
"Get more soluble fiber. 
"Include plant sterols and stanols in your diet."

Head scratcher part 1: There's no evidence - after forty years or more of examination - to show that "lower cholesterol" is a benefit for mortality reduction.  Your government, in its infinite wisdom, spent nearly a billion dollars to prove that its advice to reduce cholesterol and fat intake was in fact good for mortality reduction.  Said government failed to show any such thing.  

Second, eating plant sterols and stanols to lower cholesterol is equivalent scratching your private parts to make the sun come up sooner - I guess is might work, but the evidence is sketchy.  Sure, if you believe the conjecture that cholesterol is a cause of early mortality by causing damage to blood vessels, then it might be considered a common sense thing to use a "natural" plant based "food" to lower cholesterol.  But after forty years, and still no direct evidence that cholesterol manipulation via diet (or statin) is helpful for reduced all cause mortality - REALLY?!  A dearly beloved family member would dutifully down benecol every night on a piece of bread and announce proudly that it was "reducing" her cholesterol - how I managed to keep my pie hole shut about that I'll never know.  The kicker?  For females her age, "low cholesterol" correlates with increased mortality.  
The idea that fiber helps mortality is all the rage, but suffers, like the idea of diet to reduce cholesterol, from a lack of evidence.  Why people remain so in love with the idea is a little confusing when there are so many reasons not to down magnum doses of fiber and so little in the way of evidence that fiber is a big benefit - or any benefit.
The topic of cholesterol and causation of disease is very, very complex.  Seems like folks with "high LDL" (which can mean a lot of cholesterol packaged in LDL particles, or a large number of LDL particles, or some combination of both) have a higher correlation with heart disease; but some folks with "normal" LDL die young (Tim Russert being a prime example, his was reportedly 70, which is "low").  HDL has a correlation with reduced mortality, but efforts to raise HDL do not decrease mortality.  Insurance companies - who have a lot more at stake in your health than do your doctors - bet on your ratio of total cholesterol to LDL cholesterol.  
I read this newsletter to gauge changes in the perception of the common view.  At least this perspective - of doing what is best for you based on changes you can verify for yourself without relying upon "expert opinion" - has become obvious for the old guard.  They advise:
"Find the diet that work for you. When a friend or relative tells you how much his or her cholesterol level dropped after trying a particular diet, you may be tempted to try it yourself. If you do and after a few months you discover that you’re not getting the same benefits, you may need to chalk it up to genetic and physiological differences. There is no one-size-fits-all diet for cholesterol control. You may need to try several approaches to find one that works for you.  Although diet can be a simple and powerful way to improve cholesterol levels, it plays a bigger role for some people than for others. If your doctor suggests a lower-fat, lower-cholesterol diet, and despite your best efforts it isn’t working, you may need a different kind of diet, or medication, or both to bring cholesterol down."
It is curious to consider how this will all play out over time.  I don't see a day when all of the "experts" who have advocated low fat and statins to save the world will just have a conference and announce "what we've been telling you was bogus."  At some point, however, the truth will be too obvious for any rational denial.  The "It's the Sugar, Stupid" paper (from Monday and Wednesday's post) will be another nail in the "low fat for health" coffin, making the causality chain something like:
1. Too much sugar causes metabolic derangement (metabolic syndrome)
2. Unchecked, metabolic syndrome progresses to diabetes (full blown loss of glycemic control), and excess carbohydrate in general exacerbates the issue once one is over the metabolic syndrome threshold
3.  Diabetes predicts about a ten year shorter lifespan, and a much shorter period of active life.
The role of fat and cholesterol in this chain is minimal, and if eating high fat and high cholesterol helps you retain glycemic control and avoid metabolic syndrome, we've been in reverso-world the last 30+ years.

It's the Sugar, Folks - NYTimes.com

"Sugar is indeed toxic. It may not be the only problem with the Standard American Diet, but it’s fast becoming clear that it’s the major one."
http://opinionator.blogs.nytimes.com/2013/02/27/its-the-sugar-folks/

Wait - but it's just another epidemiological study, right?  LIke the one AC lambasted on Friday?  Yes, it is, but that does not mean it's wrong!  And, sometimes folks are out to get the one that's paranoid.

This was a unique epidemiological study; not many meet these requirements:

"...and it satisfied the longstanding “Bradford Hill” criteria for what’s called medical inference of causation by linking dose (the more sugar that’s available, the more occurrences of diabetes); duration (if sugar is available longer, the prevalence of diabetes increases); directionality (not only does diabetes increase with more sugar, it decreases with less sugar); and precedence (diabetics don’t start consuming more sugar; people who consume more sugar are more likely to become diabetics).  The key point in the article is this: “Each 150 kilocalories/person/day increase in total calorie availability related to a 0.1 percent rise in diabetes prevalence (not significant), whereas a 150 kilocalories/person/day rise in sugar availability (one 12-ounce can of soft drink) was associated with a 1.1 percent rise in diabetes prevalence.” Thus: for every 12 ounces of sugar-sweetened beverage introduced per person per day into a country’s food system, the rate of diabetes goes up 1 percent. (The study found no significant difference in results between those countries that rely more heavily on high-fructose corn syrup and those that rely primarily on cane sugar.) This is as good (or bad) as it gets, the closest thing to causation and a smoking gun that we will see. (To prove “scientific” causality you’d have to completely control the diets of thousands of people for decades. It’s as technically impossible as “proving” climate change or football-related head injuries or, for that matter, tobacco-caused cancers.)

"But as Lustig says, “This study is proof enough that sugar is toxic. Now it’s time to do something about it.”  The next steps are obvious, logical, clear and up to the Food and Drug Administration."

While I of course disagree with FURTHER government intervention in health and diet (after all, the government is the reason we all chose sugar over fat the last forty years), I'm a big fan of not overdosing yourself on sugar, as regular readers can attest.  Gary Taubes made this case very strongly and this study is if anything a validation of "Good Calories, Bad Calories".
The path through sugar to diabetes and all of the diseases of the west is well trodden and open to all - take the road less travelled by.

Observation: Sugar Is Correlated With Diabetes

Abstract

While experimental and observational studies suggest that sugar intake is associated with the development of type 2 diabetes, independent of its role in obesity, it is unclear whether alterations in sugar intake can account for differences in diabetes prevalence among overall populations. Using econometric models of repeated cross-sectional data on diabetes and nutritional components of food from 175 countries, we found that every 150 kcal/person/day increase in sugar availability (about one can of soda/day) was associated with increased diabetes prevalence by 1.1% (p <0 .001="" after="" and="" biases="" cereals="" controlling="" fibers="" food="" for="" fruits="" including="" meats="" oils="" other="" potential="" selection="" testing="" types="" u="">, total calories, overweight and obesity, period-effects, and several socioeconomic variables such as aging, urbanization and income. No other food types yielded significant individual associations with diabetes prevalence after controlling for obesity and other confounders. The impact of sugar on diabetes was independent of sedentary behavior and alcohol use, and the effect was modified but not confounded by obesity or overweight. Duration and degree of sugar exposure correlated significantly with diabetes prevalence in a dose-dependent manner, while declines in sugar exposure correlated with significant subsequent declines in diabetes rates independently of other socioeconomic, dietary and obesity prevalence changes. Differences in sugar availability statistically explain variations in diabetes prevalence rates at a population level that are not explained by physical activity, overweight or obesity.

http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0057873

There's no doubt in my tiny bean that sugar holds a causal relationship with diabetes, and this study would only reinforce such belief.  But the larger point is that this study, and others like it, should never be used to assume causal relationships.

The language tells the tale, even for those who may not be tuned into the philosophy of science.  They tried to account for all the variables, but of course, they don't know all the variables, and there's no guarantee they have accurately weighted the variables they know of.  

For example - how do they possibly know how to control for "fiber" and fiber's so called effects on blood glucose and other issues related to diabetes?  Most of what they think they know about fiber is just a derivative of other observational studies.

That Stuff Will Kill You

 

Impressive, 41 grams of HFCS in a 12 ounce can of cola, who knew.

Taubes in Mother Jones

Gary Taubes' article, Sweet Little Lies, was published in Mother Jones this month. The tag line is "The 40-year campaign to cover up evidence that sugar kills."

It starts:
"On a brisk spring Tuesday in 1976, a pair of executives from the Sugar Association stepped up to the podium of a Chicago ballroom to accept the Oscar of the public relations world, the Silver Anvil award for excellence in "the forging of public opinion." The trade group had recently pulled off one of the greatest turnarounds in PR history. For nearly a decade, the sugar industry had been buffeted by crisis after crisis as the media and the public soured on sugar and scientists began to view it as a likely cause of obesity, diabetes, and heart disease. Industry ads claiming that eating sugar helped you lose weight had been called out by the Federal Trade Commission, and the Food and Drug Administration had launched a review of whether sugar was even safe to eat. Consumption had declined 12 percent in just two years, and producers could see where that trend might lead. As John "JW" Tatem Jr. and Jack O'Connell Jr., the Sugar Association's president and director of public relations, posed that day with their trophies, their smiles only hinted at the coup they'd just pulled off."

The cover benefits from an image of a pitcher of what looks like "Kool Aid" (aka colored, flavored sugar water), modified to resemble a mélange of a skull and an apologetic smile. You can see this photo here:
http://www.motherjones.com/environment/2012/10/sugar-industry-lies-campaign

The article essentially says that there has been evidence of the health risks caused by excess sugar intake (type 2 diabetes leading to cancer, neurological disorders, and cardiovascular disease), but the industry, fearful of government regulation, used information suppression and distortion to prevent widespread discussion of these topics, preventing both regulation of the industry and execution of more definitive research.

A favorite tactic was to place folks "in the industry's pocket" as members of government panels looking into the subject. As a result, these government panels were pretty consistent in saying, essentially, "sugar's no problem." Folks, even a politician could figure out that 142 pounds of sugar (average annual consumption in the US) is not a good thing for health.

What does an industry mis-information campaign look like?
http://www.motherjones.com/slideshows/2012/10/classic-sugar-ads/eat-sugar-lose-weight

When questioned about the similarities of this case to the tobacco case, Taubes responds:
"There's a fundamental difference here that I will think change the way this plays out. With tobacco, the evidence was damning and, as I understand it, the tobacco industry tried to cover it up and make it go away. With sugar, the evidence was suggestive and the sugar industry just tried to make sure that the research to either exonerate sugar or convict it would never be done. They also worked and still work to assure that no consensus will ever be achieved. So ethically it's a different issue and it is legally as well. But now I'm stepping outside what little expertise I arguably have."

One thing that puzzles me is why the sugar industry so outperformed the beef industry in this public opinion battle. Was the beef industry so confident in its product that it felt it did not have to muzzle the government's mis-information about animal fats/saturated fats? Or, was the beef industry more dispersed and less amenable to effective representation by an industry lobby group? Perhaps they did everything they could but I just don't know about it. The irony is that the beef industry had science on its side all along, and the government sided with sugar instead. "Go figure."

How did the industry's distortions play out in real life? Here's an illustrative anecdote:
"But after flipping through The Stop & Go Fast Food Nutrition Guide, the book that healthy-living guru Steven G. Aldana had handed out at the conclusion of his talk, my fight or flight response kicked in. Aldana was on his way to the airport, and I had a question for him.

"I caught him halfway up the stairs leading to the street. "How can you say sweet tea is good for you?" I blurted out, less eloquently than I had intended. Aldana's book had given Lipton Brisk-which contains 11 teaspoons of sugars per 16-ounce can-his "You're eating healthy!" seal of approval. Earlier in my career, working as a dental director for low-income clinics in Denver, I had seen firsthand the damage these kinds of sugary drinks incur on people's teeth-never mind the causative role they may play in chronic diseases such as diabetes and obesity.

"Perched three steps above me, Aldana looked down calmly. "There is no research to support that sugar causes chronic disease," he said. Then, before I could string another sentence together, he was out the door."
http://www.motherjones.com/environment/2012/10/former-dentist-sugar-industry-lies

NOTE: Here begins the libertarian editorial, feel free to skip this is you are emotionally invested in the competence and goodness of an expansive federal government.

The USDA's credibility is right up there with the rest of our "incredible" government, from fraud laden and astonishingly unsustainable Medicare, to bankrupt (and also fraudulent) social security, to the sham debate about the "fiscal cliff".   Finding out the USDA was used as a tool of industry isn't really a surprise, but it is nonetheless tragic since so many have suffered as a result (next big expose will be of all the ways the pharmaceutical industry leverages government stooges to peddle drugs which have been significantly misrepresented with regards to efficacy).

 Our government prescribes a dietary approach that makes people sick when they are old, and then spends "a mint" to keep them alive, meaning social security won't have enough funding to keep paying them. If it wasn't real, you would not believe it could be true.

Elevated Visceral Fat: "Nobody Wants That"

The language that follows is the language of observational/epidemiological studies:

"among obese adults, visceral fat was associated with more than a twofold increased risk of developing incident diabetes (odds ratio 2.42, 95% CI 1.59 to 3.68).  In addition, developing either condition was also associated with markers of insulin resistance including elevated fructosamine levels (OR 1.95, 95% CI 1.43 to 2.67) and elevated fasting blood glucose (OR 1.88, 95% CI 1.38 to 2.56).

But there were no associations with general markers of obesity, including body mass index (BMI) or total body fat."

In other words, "these are interesting correlations."

Not that I would disagree with their conclusions:

"Our study may have implications for understanding differences between metabolically healthy and pathologic obesity."

This is interesting because not everyone that's fat is insulin resistant, and those who are develop illness as much higher rates than those who are not.

This is also interesting:

"In participants without diabetes at baseline, a number of factors were significantly and independently associated with incident diabetes in obese adults:

• Elevated visceral fat: OR 2.42, 95% CI 1.59 to 3.68 (P<0 .001=".001" li="li">
• Elevated systolic blood pressure: OR 1.26, 95% CI 1.07 to 1.48 (P=0.006)
• Elevated fructosamine levels: OR 1.95, 95% CI 1.43 to 2.67 (P<0 .001=".001" li="li">
• Elevated fasting blood glucose: OR 1.88, 95% CI 1.38 to 2.56 (P<0 .001=".001" li="li">
• Weight gain from baseline: OR 1.06, 95% CI 1.02 to 1.10 (P=0.002)
• Family history of diabetes: OR 2.32, 95% CI 1.25 to 4.29 (P=0.008)

"There were no associations for BMI, total body fat, or abdominal subcutaneous fat, they reported." 

Many of the same factors correlated with the development of insulin resistant in those not obese when the study began.

http://www.diabetesincontrol.com/index.phpoption=com_content&view=article&id=13578&cacatid=1&Itemid=17

All in all, this fits a well recognized pattern of illness - high fructosamine levels/high fructose intake, visceral fat, high blood pressure, elevated fasting glucose, weight gain, and family history of diabetes.  

Lucky for us, most of these symptoms are treatable through carb restriction - I recommend starting out at 25-50g/day to stop these symptoms, and after weight/fat/symptom normalization, many will be able to eat more carbs but maintain their wellness.  Eat meat, eggs, vegetables, nuts and seeds, little fruit or starch, no sugar/wheat.

Elevated Sugars Linked to Brain Shrinkage

"Numerous studies have shown a link between type 2 diabetes and brain shrinkage and dementia, but we haven't known much about whether people with blood sugar on the high end of normal experience these same effects. " The study involved 249 people age 60 to 64 who had blood sugar in the normal range as defined by the World Health Organization. The participants had brain scans at the start of the study and again an average of four years later.

Those with higher fasting blood sugar levels were more likely to have a loss of brain volume in the areas of the hippocampus and the amygdala, areas that are involved in memory and cognitive skills, than those with lower blood sugar levels. 

Interesting note:

A fasting blood sugar level of 180mg/dl.(10.0 mmol/l) or higher was defined as diabetes and a level of 110mg/dl(6.1 mmol/l) was considered impaired, or prediabetes. 
This part is the language of an epidemiological study:

After controlling for age, high blood pressure, smoking, alcohol use and other factors, the researchers found that blood sugar on the high end of normal accounted for six to 10 percent of the brain shrinkage. 

http://www.diabetesincontrol.com/index.php?option=com_content&view=article&id=13511&catid=1&Itemid=17

These are interesting results, in that they correlate with the widely held view that high blood sugars are injurious to the nervous system.  In fact, for a while it was fashionable to cause Alzheimer's "Type III Diabetes" or "Alzheimer's of the brain."  However, as the authors noted, epidemiological studies only suggest a possible cause, and prove nothing.  Whether or not the effect is as dramatic as showing a loss of brain tissue in four years, there are many reasons to fear high blood sugar's negative impacts on your health, and zero negative side effects of eating for glycemic control.

Mercola On Fructose

What is the link between fructose and blood pressure? Fructose in your diet raises your blood pressure in three key ways:

1. When your liver breaks down fructose, uric acid is produced as a byproduct. Uric acid also drives up your blood pressure by inhibiting nitric oxide in your blood vessels. Nitric oxide helps your blood vessels maintain their elasticity. When you consume large amounts of fructose, increasing uric acid levels drive up your blood pressure. If your uric acid levels are chronically elevated, you have an increased risk for hypertension, kidney disease, metabolic syndrome and diabetes. Large amounts of fructose also place a great strain on your liver, which is responsible for most of the metabolic burden.
2. As metabolic physician and nutrition expert Dr. Ron Rosedale has explained, insulin stores magnesium. If your insulin receptors are blunted and your cells grow resistant to insulin, you can't store magnesium, so it passes out of your body through urination. Magnesium relaxes muscles; so, when your magnesium level is low, your blood vessels will constrict rather than relax, which further raises your blood pressure.
3. Insulin causes your body to retain sodium, which in turn causes fluid retention. Fluid retention results in elevated blood pressure and can ultimately lead to congestive heart failure.

I strongly advise keeping your TOTAL fructose consumption below 25 grams per day, or as low as 15 grams if you have high blood pressure, are overweight, or diabetic.

The fructose in whole fruits is generally healthy, unless you consume large amounts, and/or in the form of fruit juices or dried fruits. Still, if you have any of the health issues just mentioned and you're consuming large amounts of fruit, you would be wise to restrict your fruit intake to under 15 grams of fructose per day as well until your condition has normalized.

http://articles.mercola.com/sites/articles/archive/2012/09/23/broccoli-health-benefits.aspx?e_cid=20120923_SNL_Art_1

As always with Dr. Mercola's posts, you have to take the good with the bad.  This article starts out by hyping the benefits of broccoli consumption, but the citations indicate the research is mostly epidemiological, which means little to me.  Not that I would disagree with four servings of broccoli per week, but I doubt this would offer the mythical benefit for most of us in terms of improving blood pressure.  

However, I like the model he's proposing above with regards to how we are such a sick, diabetic, hypertensive culture.  And with this issue, we don't have to rely on goofy science to know if it helps.  With carb restriction generally and fructose specifically, most of us will see blood pressure normalization.

I found that after carb restriction, potassium supplementation further normalized my BP, and recently met someone who's doctor recommended potassium for that purpose also, which I thought was good news.

The big takeaway - all these symptoms (high blood pressure, dis-lipidemia, visceral fat, gout, insulin resistance/diabetes) are not discrete illnesses, but representative of excess consumption of carbs in general and sugars (which almost always are about 50% fructose) specifically.

Sugar Intake and Vascular Damage

Abstract

Background: Higher intake of carbohydrates and high–glycemic index (high-GI) diets could lead to small vessel dysfunction.

Objectives: We aimed to assess the associations between intakes of high-GI and high–glycemic load (high-GL) diets, carbohydrate, and the main carbohydrate-containing food groups and retinal microvascular changes in preadolescents.

Design: Students aged 12 y (n = 2353) from a random cluster sample of 21 schools underwent detailed eye examinations. Retinal vessel caliber and fractal dimension were measured from digital retinal images. A validated semiquantitative food-frequency questionnaire was administered.

Results: After multivariable adjustment, children who consumed soft drinks once or more per day had significantly narrower mean retinal arterioles (∼1.9 μm) than did those who never or rarely consumed soft drinks (P-trend = 0.03). When the highest to lowest tertiles of carbohydrate consumption were compared, girls had significantly narrower retinal arterioles (∼1.4 μm; P-trend = 0.03) and boys had wider venules (∼2.3 μm; P-trend = 0.02). In girls only, a higher-GI diet was associated with narrower retinal arterioles (0.98-μm narrowing of retinal arteriolar caliber per SD increase in GI, P = 0.01). Carbohydrate intake and a high-GL diet were associated with greater retinal fractal dimension in girls (highest compared with lowest tertiles: P-trend = 0.003 and 0.01, respectively).

Conclusions: Greater consumption of carbohydrates and soft drinks was associated with retinal arteriolar narrowing and venular widening. Because these microvascular signs have been shown to be markers of future cardiovascular disease risk, the presence of this risk factor in children could support the need for healthy dietary patterns that include lower consumption of high-GI foods and soft drinks.

http://m.ajcn.org/content/95/5/1215.abstract?etoc

Not a brilliant insight, but certainly another reason to minimize the high sugar drinks your kids eat, even if they aren't overweight.  Even one drink per day seems to show an effect.

Cancer Sugar, Again

But some researchers will make the case, as Cantley and Thompson do, that if something other than just being fatter is causing insulin resistance to begin with, that’s quite likely the dietary cause of many cancers. If it’s sugar that causes insulin resistance, they say, then the conclusion is hard to avoid that sugar causes cancer — some cancers, at least — radical as this may seem and despite the fact that this suggestion has rarely if ever been voiced before publicly. For just this reason, neither of these men will eat sugar or high-fructose corn syrup, if they can avoid it.

“I have eliminated refined sugar from my diet and eat as little as I possibly can,” Thompson told me, “because I believe ultimately it’s something I can do to decrease my risk of cancer.” Cantley put it this way: “Sugar scares me.”

Sugar scares me too, obviously. I’d like to eat it in moderation. I’d certainly like my two sons to be able to eat it in moderation, to not overconsume it, but I don’t actually know what that means, and I’ve been reporting on this subject and studying it for more than a decade. If sugar just makes us fatter, that’s one thing. We start gaining weight, we eat less of it. But we are also talking about things we can’t see — fatty liver, insulin resistance and all that follows. Officially I’m not supposed to worry because the evidence isn’t conclusive, but I do.

Is Sugar Toxic? Gary Taubes, NYT

If the conclusion intrigues you, read all of Gary's article.  It seems pretty obvious that we were not made to eat 150 pounds+ per year of sugar, and that something like 20 pounds per year, or 25g/day, might be a prudent dose.  There are a few things that we've changed as drastically as our sugar intake over the years: industrial seed oils, grain/bean agriculture, much less sleep of much lower quality, fat soluble vitamin intake, sun exposure, and a drastic reduction in physicality.  But you can see in the paleolithic cultures that went neolithic, with Westerners around to observe them, that they got the diseases we have now with just the addition of wheat and sugar to their traditional diets.  

The good news?  When you de-sugar your palate, regular food tastes much, much better, never mind the abundant benefits in how you look feel and perform.  Eat meat, vegetables, nuts and seeds, little fruit or starch, no sugar/wheat.

Beware the Wolf in Sheep's Clothing

I eat about 80g/day of carbohydrates.  The average for Americans is between 300 and 400 grams per day.

Interesting label on a "healthy and nutritious" drink. Note the 33 grams per serving of carbs, with 4 servings per bottle, for a whopping 132 grams of carbohydrate in one bottle.  I would love to know how many purchasers drink this all in one sitting.

So, if you find you need to get a bunch of empty calories but convince yourself that you are doing yourself a favor, here's the ideal solution, which has "NO SUGAR ADDED."  It's also "ALL NATURAL FRUIT."

According to this site, a cup of blueberries has ~21g of carbs.  (http://www.carb-counter.net/fruit/1061)  That means you can get 6 cups of blueberries in just one bottle of this stuff!! Such a deal. 

Here's a smaller version of the same product:

Sorry for the sideways angle, but the numbers are:  2 servings, 29g of carbs per serving, which delivers a  nice daily jolt of 58g of carbs to start your day off on the right track.  I just can't figure out why we have this epidemic of diabetes in our country ...
(Minor edits 4 Jan 12, 2141)

Part IIb In Taubes' Rebuttal of the Palatability Conjecture

What can we take away from these studies? Well, these three papers certainly support the contention that the sugars consumed in western diets have very specific deleterious metabolic effects, and that maybe these sugars are the, or at least a proximate cause of insulin resistance and metabolic syndrome, and so, we can assume, obesity and type 2 diabetes and perhaps all the other chronic diseases that associate with these two conditions (cancer anyone?). This was the thesis of my April New York Times Magazine cover article “Is Sugar Toxic.”
http://garytaubes.com/2011/11/catching-up-on-lost-time-%e2%80%93-the-ancestral-health-symposium-food-reward-palatability-insulin-signaling-and-carbohydrates%e2%80%a6-part-iib/

Look, I know we're all going to have some sugar in our lives, I'm not deluded that a purist diet of no sugar is either easy or necessary.  I would suggest, though that increasing your intake of fructose from 5% to 20% of your total caloric intake is problematic for your health.  Further, if you are the average American knocking back close to 150 pounds of sugar per year, you shouldn't be surprised if you are as weak, fat and sick as the average American is - and just as subject to the diseases of the West (gout, cancer, heart disease and stroke, obesity, diabetes, etc). 

Eat meat, vegetables, nuts and seeds, little fruit or starch and no sugar/wheat.