THE CASE AGAINST SUGAR
By Gary Taubes
365 pp. Alfred A. Knopf.
Say your child petitioned for permission to smoke a pack of cigarettes a week. Say his or her logic was that a pack a week is better than a pack a day. No dice, right?
O.K., now substitute sugar for cigarettes.
Comparing the dangers of inhaling cigarettes with chowing down on candy bars may sound like false equivalence, but Gary Taubes’s “The Case Against Sugar” will persuade you otherwise. Here is a book on sugar that sugarcoats nothing. The stuff kills.
Taubes begins with a kick in the teeth. Sugar is not only the root cause of today’s diabetes and obesity epidemics (had these been infectious diseases, the Centers for Disease Control and Prevention would have long ago declared an emergency), but also, according to Taubes, is probably related to heart disease, hypertension, many common cancers and Alzheimer’s.
THE CASE AGAINST SUGAR
Name a long-term, degenerative disease, and chances are Taubes will point you in the same direction.
Taubes has written extensively about diet and chronic illness, notably in a 2002 New York Times Magazine cover article that challenged the low-fat orthodoxy of the day. Taubes expanded the piece into two books, “Good Calories, Bad Calories” and, several years later, “Why We Get Fat,” in which he argued that the American medical establishment had bungled this century’s biggest health crisis. Bad science and the processed-food industry have colluded to make fat public enemy No. 1 — all the while neglecting carbohydrates, especially the highly processed and easily digested kind. And these are the real culprits in the expansion of our waistlines.
In “The Case Against Sugar,” Taubes distills the carbohydrate argument further, zeroing in on sugar as the true villain. He implicates scientists, nutritionists and especially the sugar industry in what he claims amounts to a major cover-up.
Taubes’s writing is both inflammatory and copiously researched. It is also well timed. In September, a researcher at the University of California, San Francisco, uncovered documents showing that Big Sugar paid three Harvard scientists in the 1960s to play down the connection between sugar and heart disease and instead point the finger at saturated fat. Coca-Cola and candy makers made similar headlines for their forays into nutrition science, funding studies that discounted the link between sugar and obesity.
It’s tempting to predict that Taubes’s hard-charging (and I’ll add game-changing) book will diminish sugar’s dominance, sealing the fate that no ingredient could evade after such public relations disasters. But the history of sugar in this country suggests it won’t be that easy. Here is where Taubes is at his most persuasive, tracing sugar’s unique and intractable place in the American diet.
Start with World War II as an example, when the government smoothed the way for sugar rationing by arguing that sugar was not part of a healthy diet. The American Medical Association agreed and recommended severely limiting consumption. Alarmed by the possibility of an American public that could learn to live without sugar, the industry founded the Sugar Research Foundation to proselytize its benefits. As Taubes sees it, the S.R.F. may have been created in the spirit of other industry-funded research programs — to promote and defend a product — but it helped establish relationships with scientists like the ones recently reported on at Harvard in the 1960s, and it institutionalized an aggressive, attack-dog public relations strategy that remains prevalent and pernicious to this day (tactics that the tobacco industry would also adopt).
With the rise of new calorie-counting dieting fads in the 1950s, the industry responded with a coordinated offensive. Blanketing daily newspapers with advertisements, it argued, successfully it turned out, that since obesity was caused by excess consumption of calories — a calorie was a calorie, dogma at the time — all foods should be restricted equally. Sugar has only 16 calories a teaspoon; why should it be disproportionately demonized?
The 1960s and ’70s saw a similar pattern: another threat in the form of new evidence implicating sugar, another coordinated response.
Just when it looked as if the sugar industry, for all its campaigning, could no longer overrule scientific fact, it was saved by saturated fat. The rising belief that dietary fat consumption was the cause of obesity and heart disease — which had been written about sporadically for decades — suddenly coalesced into fact, shifting the public’s attention away from sugar. This wasn’t planned or paid for. It was just dumb luck. The American Heart Association, long considered unbiased and authoritative, played a crucial role by blaming fat and cholesterol for heart disease. The press, Congress and the Department of Agriculture followed suit.
Then things went totally bananas. High-fructose corn syrup, which is just as deleterious as sugar, got a passing grade from scientists (especially for diabetics!) and went mainstream in the ’80s and ’90s. Same killer, new disguise: Americans were seduced by the sweet stuff all over again. A new category of products presented as health foods, like sports drinks and low-fat yogurt, played a sort of shell game by advertising that the bulk of their calories came from high-fructose corn syrup, without letting on to consumers that this was just another form of sugar. Learning about this made my heart hurt.
So, after decades of scrambled and spurious dietary advice, where are we now? There is a growing consensus in the medical community that a condition known as “metabolic syndrome” is perhaps the greatest predictor of heart disease and diabetes. Signs of the syndrome include obesity, high blood pressure and, more than anything, insulin resistance — which puts a particularly heavy strain on the body.
And what causes insulin resistance and metabolic syndrome? Taubes blames sugar, the “dietary trigger” hiding in plain sight for over half a century. And if he’s right, he could prove its guilt once and for all.
But is he right? Taubes, who no doubt finds the answer blindingly obvious, nonetheless poses the question himself. Is sugar “the primary cause of insulin resistance and metabolic syndrome and therefore obesity, diabetes and heart disease”? His answer: “It certainly could be.”
I know, I know — it’s the prosecutorial equivalent of a deflating balloon. But Taubes explains his caution by reminding us that we are no longer dealing with deficiency diseases, like scurvy, which can be solved with a single magic bullet like vitamin C. We’re talking about degenerative diseases, which take a long time to develop — a lifetime of sweets, in other words — and (frustratingly, if you’re out to prove the hypothesis) don’t develop in everyone.
If you’re like me, you’ve read this review just as I read Taubes’s book — respectfully interested in the history and the facts, but really wanting to be told how much sugar is too much. Taubes anticipates our self-interest, ending the book with a chapter just for us: “How Little Is Still Too Much?” But like some cryptic oracle, he answers the question with still more questions: How many cigarettes are too many cigarettes? What if the person who smoked a pack a week outlived the person who smoked a pack a day? Would we conclude that inhaling a pack of cigarettes a week is safe?
Herein lies Taubes’s key point, and it’s sort of a life lesson. We will never know for certain. Sugar may once again get off scot-free, because there is no definitive experiment or algorithm that can be developed to remove all doubt, no practical way to know for sure to what extent it’s killing us. The only certainty is that Big Sugar will continue to fight for its exoneration. Faced with more damning evidence, the industry will obfuscate rather than enlighten. It will insist that there are “two sides” to the story, and will corral skeptical scientists — readily available on any subject — to invalidate or at least cast doubt on solid medical consensus.
There’s another certainty, too — one that Taubes doesn’t acknowledge. When it comes to our health, sugar itself might be largely to blame, but the story can’t end there. It’s tempting to think — and Taubes insinuates — that if we managed to cut sugar out of our diets altogether, the chronic diseases discussed in this book would disappear. But that ignores a whole ecosystem of issues — our patterns of eating and excess, our poisoned environment — that informs our well-being. Put simply: Remove sugar and we’ll still be sick.
Our job here — and not only here, but with everything from tobacco to global warming — is to override the imperfect, long haul to scientific certainty and instead follow the precautionary principle, which means recognizing what’s staring us in the face and acting on it as if our health hangs in the balance. Because it does.