Is Sugar Killing Us?
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Experts warn that it may have an outsize role in causing obesity and diabetes—thus increasing the risk of chronic illnesses such as heart disease

By Gary Taubes

• Dec. 9, 2016 12:10 p.m. ET

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Photo: Getty Images

In the 1960s, researchers began suggesting that sugar might play a part in producing a cluster of biochemical abnormalities now known as ‘metabolic syndrome.’

At the risk of being a Grinch, the Christmas season is a pretty good time to consider the possibility that sugar is killing us. It is yet another holiday in which sweets play a primary role, with candy canes dangling on trees, cookies or Coca-Cola set aside for Santa and visions of sugar plums (which are not fruit but hard candies) dancing in children’s heads.

Many argue that sugar in moderation is benign, but that assumption has been up for debate for as long as we have added sugar to our diets. Anti-sugar forces (myself included) continue to warn that sugar—both the crystalline variety that we put in our coffee and high-fructose corn syrup—may be a fundamental cause of disease, particularly a condition known as insulin resistance. If we are right, sugar has a uniquely powerful role in causing obesity and diabetes—and thus increases our risk of developing the major chronic illnesses, such as heart disease, associated with these conditions.

This debate is not new. Western sugar consumption surged in the mid-19th century with the growth of the candy, chocolate and ice-cream industries. Soft drinks were added to the mix in the 1880s—first root beer, then Dr Pepper, then Coca-Cola and Pepsi. By the 1920s, as Prohibition spurred the nation to turn from alcohol to sugar, yearly sugar sales in the U.S. passed 100 pounds per capita for the first time.

Physicians began to condemn sugar for many illnesses, including rheumatism, gallstones, jaundice and cancer. They noted that diabetes—virtually nonexistent in hospital inpatient and mortality records through the 1850s—had become much more common since the Civil War. In 1924, New York City’s health commissioner, Haven Emerson, argued that sugar consumption was the culprit; skeptics blamed the epidemic on gluttony and sloth.

The sweetening of our national diet accelerated when inexpensive home refrigerators made their debut in the 1930s, letting Americans consume cold soft drinks in quantity at home. With the invention of frozen concentrates after World War II, fruit juices became a staple of American breakfasts.

Breakfast cereals were originally created as a health food to help digestion, and the industry’s early nutritionists were firmly anti-sugar. But once one manufacturer opted for profit over health—Post with Sugar Crisp in the late 1940s—the realities of competition soon won out. By the 1960s, children’s breakfasts had been transformed into lower-fat versions of dessert, and Saturday-morning television shows were dedicated to selling sugary cereals to children.

The final ingredient in the sweetening of our national diet arrived in the 1970s: high-fructose corn syrup, a variation on the chemical components of sugar. By 1999, annual sales of these sweeteners had soared to more than 150 pounds per person, coinciding with a corresponding surge in the prevalence of obesity and diabetes.

The sugar industry has long defended itself against the notion that sugar is uniquely fattening by repeating the mantra that a calorie is a calorie. The worst that can be said of sugar, the industry argues, is that it tastes good, which leads us to consume too much of it. “There is no difference between the calories that come from sugar or steak or grapefruit or ice cream,” proclaimed industry ads in the 1950s.

That is not actually true, though nutritionists have been slow to come around. Beginning in the 1960s, researchers led by the British nutritionist John Yudkin began to publish the results of experiments in animals and trials in humans suggesting that sugar’s distinctive chemistry had a role in producing an entire cluster of biochemical abnormalities known today as “metabolic syndrome.”

Among these abnormalities is resistance to the hormone insulin, which orchestrates the body’s use of fuels—proteins, carbohydrates and fats, and whether we store them or burn them. That key function apparently goes awry when we consume too much sugar and our cells resist the hormone. Insulin resistance is also the fundamental defect in Type 2 diabetes, the most common form of the disease, and it is common in obesity as well.

The Centers for Disease Control and Prevention estimates that some 75 million Americans now suffer from metabolic syndrome. If sugar consumption is the trigger, as 50 years of research suggests, then it might be as much of a direct cause of diabetes as smoking cigarettes is of lung cancer. Without sugar in our diets, diabetes might be an exceedingly rare disease—as it appears once to have been.

When Yudkin and others suggested as much in the 1970s, the consensus opinion among nutritionists and physicians was that dietary fat was the primary dietary evil; they considered sugar relatively benign. We have been living with the consequences ever since.

As the sugar industry is quick to point out, the evidence for the hypothesized chain of cause and unfortunate effects—eat sugar, become insulin-resistant, fatter and diabetic and then die prematurely—is ambiguous. It will probably stay that way. The National Institutes of Health have never seen the need for the expensive clinical trials that would be needed for a rigorous study of the issue.

Indeed, who could doubt the outcome of research that would ask tens of thousands of Americans to avoid sugar and compare them to tens of thousands of others enjoying a diet of Froot Loops, cupcakes and sugary beverages? Not even sugar-industry executives would be surprised to find that the sugar-avoiders were healthier. If nothing else, though, wouldn’t it be nice to know for sure that a lifetime without cakes and cookies is worth the trade-off?

The CDC estimates that obesity and diabetes now cost the U.S. health-care system some $1 billion a day. Spending a single day’s worth of that financial burden to find out whether we are really killing ourselves prematurely with sugar, even when consumed in moderate amounts, would not be a hard expense to justify.

—Mr. Taubes is the co-founder and senior scientific adviser of the Nutrition Science Initiative and the author of “The Case Against Sugar,” out Dec. 27 from Knopf. 

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