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John Yudkin: the man who tried to warn us about sugar

230 points| tomhoward | 12 years ago |smh.com.au

243 comments

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[+] victorhooi|12 years ago|reply
I'm currently reading "The Low-Carb Fraud", by Dr. T. Colin Campbell, who was one of the original authors of the China Study.

http://www.amazon.com/The-Low-Carb-Fraud-Colin-Campbell/dp/1...

Campbell has multiple degrees in biochemistry and nutrition, and from what I can tell, seems to be pretty well respected in his field.

On the other hand, Gary Taube, who wrote Good Calories, Bad Calories, and who people here seem to hold up as some kind of nutritional guru - basically is a science writer, with no formal education in nutrition at all.

Campbell basically spends the first few chapters debunking many of Gary Taubes's conclusions, and then talking about the current low-carb fads.

Definitely a good read, and approachable.

[+] jimeuxx|12 years ago|reply
Lustig could no doubt write some great posts here about growth hacking and selling your product, but if there's one thing he's proven about nutrition, it's that he's no one to be taken seriously when talking about it. One taste of what Joe Public doesn't see in his unintended hyperbole is here: http://sweetenerstudies.com/sites/default/files/resources/fi...

Blaming sugar for everything is no better than what the fat-bashing crowd do. It leads to self-parodying solutions like the "keto-adapted" lifestyle. We don't eat rice or bananas because refined sugar is to blame for all the ills of the world. Those crazy Japanese are probably just lying about their lack of heart disease anyway (when we remember the place exists at all).

As long as people only understand nutrition in terms of reductionist extremes, "alternative" diets are going to continue being a bad joke that achieves little more than inflating the ego and bank balance of people like Lustig.

[+] ynniv|12 years ago|reply
Wow, thanks for linking a really awful rebuttal. Not only does "Mark Kern, PHD, RD, CSSD, Professor of Exercise and Nutritional Sciences" start off by saying that Lustig is inherently biased by selling a book "Even if all proceeds are being donated to charity", he later goes on to drop such gems as:

The key for preventing obesity and metabolic syndrome is to avoid consuming excessive energy (Calories)

Maybe this is still debated in the (surely non-profit) exercise world, but I see no evidence that eating too many calories of lean meat would cause metabolic syndrome, or that limiting daily intake to 2000 calories of soda would cause one to become healthier.

Much of Kern's lengthy rebuttal are technical points that are beyond me to evaluate, but I suspect that the book is intended for a non academic medical audience. In fact Kern says

It is possible that the author’s intent was to simplify these processes for the reader, but doing so inaccurately calls into question his knowledge of metabolism, upon which he bases much of his book.

Perhaps one could use other material he has authored for a technical audience. And Kern is pedantic with quotes like "real food doesn’t have or need a Nutrition Facts Label". A casual reader would understand that a mango does not have a complicated ingredient list, Kern says:

While it is true that labels do not need to appear on unpackaged foods such as a produce, the Code of Federal Regulations is clear regarding nutrient labeling for these types of foods. The regulation from the Federal government is that nutrition facts must voluntarily be posted for at least 90% of fresh food items in a conspicuous place by at least 60% of companies that sell food.

Perhaps Kern doesn't understand who the audience of a trade book is. Kern also cites many studies that I'm not going to track down and evaluate for their own biases.

Giving talks, writing papers and selling books is how our world works. If that's the only thing Lustig is doing wrong, then he's doing alright by me.

but if there's one thing he's proven about nutrition, it's that he's no one to be taken seriously when talking about it

If you're going to grind your axe here, please make better arguments.

[+] mistermann|12 years ago|reply
> As long as people only understand nutrition in terms of reductionist extremes, "alternative" diets are going to continue being a bad joke that achieves little more than inflating the ego and bank balance of people like Lustig.

That is demonstrably false both in the laboratory but more importantly in massive amounts of anecdotal experience by regular folks. Go read some fitness and diet forums, you think all those people who tried various different diets are imagining they're losing 20, 40, 100+ pounds on low carb diets?

[+] PakG1|12 years ago|reply
The underlying premise that there's something strange about the correlation between the rise of sugar and the rise of health issues is stark. Obviously, we can't say that correlation = causation. But such data points should be taken seriously for more investigation, much like for example, global warming (which is a debate that I still don't completely understand either).

This is the key quote for me:

Yudkin's detractors had one trump card: his evidence often relied on observations, rather than on explanations, of rising obesity, heart disease and diabetes rates. "He could tell you these things were happening but not why, or at least not in a scientifically acceptable way," says David Gillespie, author of the bestselling Sweet Poison. "Three or four of the hormones that would explain his theories had not been discovered."

Let's apply that towards global warming. This reminds me of Al Gore's little movie where he talks about his old prof gathering climate data. The temperature kept going up, and he could not figure out why. Lots of data, no explanation. What should have been the proper response? Dismissal because there's no explanation or further study?

I worry that there are other things where the timeline required to truly observe and understand things is not possible, and that risks are completely accepted because no current viable explanation can be made as to why the thing is actually dangerous. The biggest one for me is wireless communications. Can cell phones and other wireless devices cause cancer? Generally, we say no. But we don't have enough data to truly say no, and we probably won't have that data until kids born after 2000 become geriatrics, as they'll be the first generation to truly grow up from birth in an age with ubiquitous cell phones. And besides that, it's not like anyone's been able to provide any widely acceptable explanation on the matter anyway. So we'll just trundle along blindly because our current data says there's no risk. I'm mostly sad because what other choice do we really have? You can't turn back the clock on technological progress even if you wanted to.

[+] adwf|12 years ago|reply
Gonna have to call you up on the cell phones I'm afraid. It has been pretty conclusively proven that there is no link between cell phone radiation and cancer [1]. Unless you call a study of 420,000 people over 20 years insignificant...

And as for a mechanical explanation why cell phone radiation doesn't cause cancer: It's because the radiation type used is non-ionising! As for thermal effects, it's orders of magnitude less than standing in direct sunlight. It's basic physics. (Well perhaps not the ionising radiation part, Einstein got a Nobel for the photoelectric effect...)

This myth has been debunked as pure fear-mongering time and time again. The only slight recommendations that are issued are for longer term studies - simply because cell phones haven't really been in heavy usage for more than 20 years. Pure fear of the unknown, despite study after study showing no effect.

[1] http://jnci.oxfordjournals.org/content/98/23/1707.abstract

[+] wozniacki|12 years ago|reply
I know that Business Insider is practically detested in these parts, but the piece linked here neatly summarizes - with line charts - the misguided dietary trends in the U.S., that have led to the high prevalence of chronic conditions like obesity and diabetes and the general state of poor health and thereby, soaring medical costs.

http://www.businessinsider.com/whats-wrong-with-the-modern-d...

[+] eliben|12 years ago|reply
Interesting to see this, having just finished one of Gary Taubes' books and reading another. Especially "Good Calories, Bad Calories" is an extremely well-researched work talking exactly about the issues discussed in this article, presenting countless researches and scientific facts related to it.
[+] Jun8|12 years ago|reply
As they say: "The dose makes the poison". Stating that sugar is toxic, as Lustig and others do, (see his talk on YouTube or http://www.nytimes.com/2011/04/17/magazine/mag-17Sugar-t.htm...) to me does not make much sense in fighting against the super high levels of consumption: When you argue a position that's too far removed from most people's accepted positions, they tend to tune you out. Note that high-fructose corn syrup (water+glucose+fructose) is included in this generalized definition of "sugar", which, of course nobody would add to their coffee or tea (that would be sucrose or table sugar), but is now used ubiquitously in the food industry (http://science.howstuffworks.com/innovation/edible-innovatio...). A better option would be to single HFCS out and fight against its use.

While reading this the following question came to mind: If Yudkin's results were so groundbreaking and well backed up, why was he kind of shut off from the academic community. Stating that the "sugar lobby" ended his career sounds a bit too far fetched.

[+] spindritf|12 years ago|reply
Note that high-fructose corn syrup (water+glucose+fructose) is included in this generalized definition of "sugar"

I cannot imagine a narrower definition of "sugar" than glucose+fructose. It's exactly what you add to your coffee and tea, just in the form of sucrose crystals.

There is no functional difference between HFCS and table sugar. If the regulators/activists force the food industry to replace HFCS with some other sugar, all they'll achieve is a minor increase in prices.

[+] specialist|12 years ago|reply
Stating that sugar is toxic, as Lustig and others do...

No. Lustig explains that fructose is toxic, detailing its metabolic pathway.

A better option would be to single HFCS out and fight against its use.

Exactly. Just as Lustig and others have clearly, exhaustively, definitively, pointed out, ad nauseam.

If Yudkin's results were so groundbreaking and well backed up, why was he kind of shut off from the academic community.

As the article clearly explains, Yudkin had the data, but not the explanation. e.g. 3 of the 4 hormones needed to explain what was happening hadn't been discovered yet.

[+] shpx|12 years ago|reply
This must be what it feels like when people started accepting that smoking or drunk driving is bad for you. I mean I didn't even think to consider that sugar is essentially a drug...
[+] Pxtl|12 years ago|reply
I'm just guessing, but it occurs to me that prior to the 20th century the average European probably consumed more ethanol than refined sugar.
[+] gnusouth|12 years ago|reply
More info.

Anti-sugar: http://www.abc.net.au/catalyst/stories/3821440.htm

Anti-anti-sugar: http://www.abc.net.au/mediawatch/transcripts/s3888657.htm

The whole thing strikes me as quite sensationalist, and I suspect that digging into the research would affirm the cholesterol <-> heart disease link. For now, I'll trust the scientific consensus over these crackpot types.

[+] ynniv|12 years ago|reply
Week old accounts with no prior comments shouldn't be allowed to use hot button words like "crackpot". They should probably include IP addresses in their comments as well.
[+] sjtrny|12 years ago|reply
It's not as simple as "sugar is poison". Some form of "sugar" is in virtually everything we eat. It is unavoidable. Just stick to the rule of "Eat food, not too much, mostly plants" and quit screaming about sugar.
[+] pvnick|12 years ago|reply
I'm getting sick of this ignorant sugar alarmism. Sugar is not the culprit behind all the diseases listed in the article. Obesity is [5] [6]. Unless of course you're talking about cavities. Then not brushing your teeth is the culprit. The reason sugar gets such a bad rep is that high-sugar foods tend to be less-filling and lead to overeating [1]. Stay at a healthy weight by controlling caloric consumption [2].

The article mentions such scientific evidence as "nearly two-thirds of the studies cited there to repudiate Lustig's views were funded by Coca-Cola." Seriously?

Normally I wouldn't care - sugar alarmism = more candy for me - except that, as the article notes, "Lustig ... calls for sugar to be treated as a toxin, like alcohol and tobacco, and for sugar-laden foods to be taxed, labelled with health warnings and banned for anyone under 18." That's just bullshit extremism. Doughnuts, one of my favorite foods, can be part of a healthy diet just like anything else. In fact, sugar is fantastic for stimulating muscle growth [3], and can help with diet adherence during a caloric deficit [4].

[1] http://en.wikipedia.org/wiki/Insulin_index - this page lists satiety indexes for common foods. Notice all the lowest scores are bakery goods and sugary snacks.

[2] http://ajcn.nutrition.org/content/early/2009/10/14/ajcn.2009...

[3] http://jcs.biologists.org/content/122/20/3589.full

[4] http://www.ncbi.nlm.nih.gov/pubmed/11126336?ordinalpos=47&it...

[5] http://www.nhlbi.nih.gov/health/health-topics/topics/obe/ris...

[6] http://www.ncbi.nlm.nih.gov/pubmed/19801534

Edit: People are taking my words out of context. This is my reply to another comment below that elucidates my meaning: "I advocate moderation and balance. Consume reasonable calorie and macronutrient (protein, fat, carbohydrate) quantities. Eat what allows you to do that. For me, those carbs come from doughnuts and candy but also from brown rice and pasta. Just like my meats include both lean meats (chicken breast) and fatty, delicious meats (bacon). Combine this with exercise and all you'll avoid all the scary things the article talks about."

[+] eclipxe|12 years ago|reply
No, the reason sugar gets a bad rep is because of what it does to your body. The insulin response to sugar is the primary way your body stores fat and sugar itself is readily converted to fat. The glucose & fructose spikes are also source of inflammation. It is believed that this inflammation is the cause of some of the damage related to heart disease, etc.
[+] mishkovski|12 years ago|reply
Sugar is not the culprit behind all the diseases listed in the article. Obesity is

And sugar is culprit behind overeating and obesity.

[+] smtddr|12 years ago|reply
>>Doughnuts, one of my favorite foods, can be part of a healthy diet just like anything else.

When you say "doughnut" you mean this[1], right? If so that's 100%, Grade A nonsense and abruptly ends any consideration I was giving your comment.

1. http://twincitiesdonut.com/images/donut.jpg

[+] dimitar|12 years ago|reply
As you said elsewhere in the thread its calories-in, calories-out.

This simple fact is a very big win for science, but it is very unpopular - no one likes to actually calculate calories, so a lot of people prescribe to dubious unbalanced diets that sound convincing by catering to their food preferences and aesthetics.

No regulation short of destroying consumer choice and imposing an approved-foods-list will defeat obesity. Trying to just limit sugar is pointless because industry and consumers will substitute the current form of sugar for something else, raising the cost of food in the meantime, which will hurt the poor. (Just like an import quota on sugar in the US has not reduced consumption of sweets, because sugar got substituted for HFCS).

I think the best way to solve obesity is to find some chemicals that satisfy appetite easily and cheaply or sweeteners that are as good or better tasting than sugars, but are not caloric. (Aspartame is very sweet, but tastes significantly worse than sugar).

[+] alexc05|12 years ago|reply
Yet the pendulum has swung so far away from "just a bit of Moderation" that the now all-pervasive sugar (virtually) cannot be avoided.

Left to their own devices, industry will NOT comply so regulation is a valid tool to stave off the massive public health risk that unchecked industry has introduced.

While muscle growth does require sugars, it is not required in anywhere near the amounts present in every single food on shelves.

Your arguments reek of industry propoganda and astroturfing. They've got an air of populism and fallisciousness about them... "But sugar is needed for muscles... See science?"

Come on... You're one of those paid forum commenters we keep reading about right? Some guerilla marketer working for big sugar? Is it an agency with lots if clients or just one topic?

[+] sillysaurus2|12 years ago|reply
Doughnuts, one of my favorite foods, can be part of a healthy diet

Can they?

[+] PakG1|12 years ago|reply
I'd like for you to actually explain how it's wrong to say that replacing a fat-heavy diet with a sugar-heavy diet is bad for health. You dismiss their premises and conclusions by saying they're looking at the wrong culprit for health problems. I'd prefer if you dealt with their premises and conclusions by falsifying said premises and conclusions.
[+] dilap|12 years ago|reply
"Very few fossil hominins have cavities. The decline in oral health started with agriculture and resulting changes to oral microbiome." — John Hawks (paleoanthropologist).

Diet has a lot to do with cavities.

[+] saganus|12 years ago|reply
An acquaintance I once met, that used to work on the product design team for one of the major brands of snack/potato chips makers, had a witty response to what a friend asked, along the lines of:

"so, tell us, how can you work at something that you know is bad for people's health?" and he answered:

"I am certainly used to the opinion that garbage food is bad for your health, and what I think is that garbage food does NOT exist. What it actually DO exist are garbage diets. If you eat one bag of chips every now and then, nothing bad will happen to you. However if you eat one bag a day for 10 years, you will probably feel the effects."

So the bottom line is as usual, everything in moderation. I mean, the often used analogy is with water. You can't live without drinking it and yet you can certainly die if you drink too much of it.

Isn't this like an overdone debate? I mean, you can definitely start an alarmist attitude towards almost anything you can think of, no?

[+] GFK_of_xmaspast|12 years ago|reply
It's not the smoking that gets you, it's the lung cancer and emphysema.
[+] nnq|12 years ago|reply
You're right, but the extremely low visibility of wonderful resources like http://www.youtube.com/watch?v=dBnniua6-oM (and the articles it's based on, even in the medical research community) make "pulling in the other direction" (even if it's just as wrong) a good course of action for achieving a properly balanced view of the scientific facts.
[+] stdbrouw|12 years ago|reply
Re: 4, don't you think it's a bit of a stretch to go from a study that notes that temporary carbohydrate overfeeding can increase leptin, to saying that a little bit of sugar will keep you on your diet? (It's an intriguing result, no doubt, just not something that I'd make sweeping extrapolations from.)
[+] mullingitover|12 years ago|reply
Aspirin can be good for you too, but I wouldn't go drinking 32 ounces of aspirin solution every day.
[+] CEyzaguirre|12 years ago|reply
Because skinny people don't get diabetes right? /s
[+] b1ueocean|12 years ago|reply
Parents really need to stop giving this poison to their children. All birthday parties & events geared towards kids has this poison as the main attraction. And don't get me started on breakfast cereals....
[+] EpicEng|12 years ago|reply
Oh c'mon, lighten up. Sure, kids shouldn't be eating frosted flakes and garbage like that on a regular basis, but you're not going to give your kid a birthday cake? No occasional ice cream cones? Must be fun to be your kid. Everything in moderation.
[+] miralabs|12 years ago|reply
Whats needed is the reduction of added sugars on everyday food..mostly processed food. I dont think we should go to the extent of not having cakes or ice cream on special occasions, that is not the problem.
[+] wambotron|12 years ago|reply
Who are you to say my kids can't eat Arsenic Flakes or Lead-frosted Crunchies?
[+] sandGorgon|12 years ago|reply
Here's a very interesting, recent research paper that seems to corroborate AND defy the "sugar is evil" statement:

Dietary composition and its associations with insulin sensitivity and insulin secretion in youth. - While long-term excess of energy intake has been shown to lead to overweight and obesity, dietary macronutrient composition is not independently correlated with insulin sensitivity (IS) and insulin secretion (ISct). HOWEVER, For every 1 % increase in daily protein intake (%), Area-Under-Curve(AUC) Insulin/Glucose t= 30 min decreased by 1·1 % (P= 0·033).

FYI - increase of AUC is correlated with glycemic response to foods. [2]

[1] http://www.ncbi.nlm.nih.gov/pubmed/24047611 [2] http://care.diabetesjournals.org/content/13/2/172.abstract

[+] fredgrott|12 years ago|reply
a former molecular bio major,

Be careful folks.. the sugar they are referring to is corn syrup which was used as fat taste replacement..sucrose

fructose in small doses is still fine..although do not use it a diet plan as its a hunger enhancer as it blocks a body released chemical that tells are body to stop eating.

[+] voltagex_|12 years ago|reply
>blocks a body released chemical that tells are body to stop eating

Got any more info on this?

[+] jjindev|12 years ago|reply
I am not a nutritionist or a biochemist, but as a guy with an old BS Chem and a general knowledge, it does not surprise me to hear (again) that we are not all bomb calorimeters. We have long known that our metabolic pathways are neither uniform nor universal. There is no surprise there. When you eat fat, carbohydrate, or cellulose, different things happen.

Thus, I think the extreme "calories is calories" argument is anti-scientific.

Given the real complexity, I personally favor a varied and omnivorous diet, avoiding things both unnatural in their manufacture but also unnatural in their availability. A diet high in sugar is not natural. It would be very surprising if evolution and the evolution of our accompanying microbiome prepared us for it.

[+] yetanotherphd|12 years ago|reply
I don't know if this man's views on sugar are accurate, but things like:

>''Reviews of the body of scientific evidence by expert committees have concluded that consuming sugar as part of a balanced diet does not induce lifestyle diseases such as diabetes and heart disease,'' he says.If you look up Robert Lustig on Wikipedia, nearly two-thirds of the studies cited there to repudiate Lustig's views were funded by Coca-Cola.

really disturb me. I think there is something wrong with are intellectual culture when we give completely undeserved credulity to studies with obvious biases.

[+] cjf4|12 years ago|reply
Calories in v calories out is absolute in terms of weight loss/gain, but that's just a quantitative measure, not a qualitative one. For instance, the famed "Twinkies at a Caloric Deficit" diet will cause you to lose weight, but not in any sort of good way, and will do all sorts of terrible things to your health, not the least of which is deprivation of important micro and macro nutrients.

Sugar isn't inherently "bad", but the way most people consume it is. High sugar foods, in essence, have very poor bang for your caloric buck.