CardioExchange Archive

CardioExchange, an NEJM practice community for medical professionals dedicated to improving cardiac patient care, was active from 2009 to 2015. CardioExchange fostered discussion between clinicians from across the globe.

April 14th, 2011

Sugar Is Not So Sweet

You may want to skip your Sunday sweet this week. On Sunday, the New York Times magazine section will publish a major assault on sugar by the veteran and often controversial journalist Gary Taubes. In a long and detailed feature article, Taubes outlines the case for the prosecution against sugar, along with its nearly identical and ubiquitous cousin, high-fructose corn syrup, which he argues may well be a chronic toxin that can cause not only obesity, cardiovascular disease, and diabetes, but also cancer. Taubes writes:

It very well may be true that sugar and high-fructose corn syrup, because of the unique way in which we metabolize fructose and at the levels we now consume it, cause fat to accumulate in our livers followed by insulin resistance and metabolic syndrome, and so trigger the process that leads to heart disease, diabetes and obesity. They could indeed be toxic, but they take years to do their damage. It doesn’t happen overnight. Until long-term studies are done, we won’t know for sure.

Regarding cancer, Taubes follows the scientific trail linking insulin and insulin-like growth factor to many human cancers. He writes:

If it’s sugar that causes insulin resistance… 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.

Taubes acknowledges that the evidence isn’t perfect, but wryly concludes with the words: “Officially I’m not supposed to worry because the evidence isn’t conclusive, but I do.”

Readers may be interested to learn that Taubes’s perspective aligns closely with that of Robert Lustig, a pediatric endocrinologist at UCSF. Lustig has a YouTube video lecture about sugar that has received more than 800,000 views (and will probably get a whole lot more views after Sunday).

Categories: Prevention
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4 Responses to “Sugar Is Not So Sweet”

  1. William DeMedio, MD says:
    April 15, 2011 at 8:36 pm

    Its not sugar that is the problem, it is the excess consumption and excess insulin. Glucose is necessary for brain and muscle metabolism. The brain must get at least 50% of its energy from glucose. Glucose is a metabolic product of fructose and sucrose. Everything in moderation is my motto. If you claim that sugar and sunshine are carcinogens, you may as well say life is a carcinogen. People like Taubes would put on a special “sugar tax” to dissuade people from eating it. Worse yet, they could impose prohibition on it like tey did alcohol. We must educate our people not to be lazy, eat too much, and get fat. This is where the true problem lies.

    Competing interests pertaining specifically to this post, comment, or both:
    I own the Domino sugar refinery in Baltimore (only kidding)

    • Jonathan Levi, MD says:
      April 16, 2011 at 3:59 pm

      While I don’t know whether sucrose and HFCS are toxic, this letter seems to me to miss the point. Of course we need glucose, and of course there are ways to get it (in starch, fresh fruit, etc.) that involve either no fructose or much less than the above substances supply. My inclination (and that’s all it is) after reading this article, is to cut my sucrose consumption substantially and to eliminate HFCS entirely, if possible.

      Competing interests pertaining specifically to this post, comment, or both:
      None

  2. Leon Hyman, Ms M.D. says:
    April 15, 2011 at 10:05 pm

    Taube is not a sweet person.

    Competing interests pertaining specifically to this post, comment, or both:
    I have not had a drink of regular soda(pop) in over 25 years

  3. Jeffrey Schneider, Physician Assistant says:
    April 19, 2011 at 7:22 pm

    After reading his book, Good Calories, Bad Calories, the history of food
    and diet was well researched and I believe that Ancel Keys and his theory
    was forced down the scientific and the poliitcal and the public’s throat.
    Specifically, that fat and cholesterol hence meat and saturated fats were bad and caused heart disease and that a low fat high carb diet was good for us. If you are constantly eating carbs or one kind or another through the day circulating insulin levels will stay elevated and its this chronic elevated state of insulin that is responsible for chronic inflammation and chronic inflammation is at the root of many many diseases. I personally went over a year on this diet and saw all my heart profile markers return to normal plus a large elevation in HDL’s. Granted the diet can get boring, but the truth of the matter is that Gary Taubes’ research is accurate.

    Competing interests pertaining specifically to this post, comment, or both:
    I have no conflicts of interest.