Faced recently with the need for a new jar of mayonnaise, the two opened containers in our refrigerator rejected by my spouse because of expiration dates (another questionable issue), I went to our local supermarket to pick up a few things which included that new jar of mayonnaise and also a box of Cheerios, for many years my favorite cold cereal. We try not to buy foods that have “added sugar” so I read the ingredients on each brand of mayonnaise, looking for one without sugar. Amazing, I could not find a single brand that did not have that unneeded and unacceptable ingredient.

So on to the breakfast cereals section where I grabbed a box of Cheerios and out of curiosity checked those ingredients also. I could not believe that sugar was one of the ingredients. I mean, when I was a kid, I was allowed that little spoonful of sugar sprinkled on the corn flakes or Cheerios before the milk and I presume that many people continue to sweeten their cold cereal in this way. So why is sugar already in the Cheerios rendering that teaspoonful redundant? And how long has General Mills been adding sugar to my Cheerios?

The same goes for so many breads in this supermarket. I usually buy the best bread I can here – La Brea Bakery whole grain loaf – brown, crisp crust, not packaged but in a simple bag and not sliced. I checked the ingredients – yes, whole wheat flour, millet, flaxseed, sunflower seed and all the other good things in a quality bread, and all non-GMO to boot, but then I blinked – there it was – sugar – in my otherwise very healthy bread. Why on earth is sugar needed in bread?

And have you ever tried to find peanut butter without sugar? It’s really difficult – all the major brands contain sugar. And, how interesting, when you do happen to locate a lesser known brand that contains no sugar, the ingredients are very simple – there’s only one – “peanuts”. Why on earth can’t all the major brands make peanut butter in this way? There is absolutely no need for sugar or any other added ingredients in something as simple and delicious all by itself as peanut butter.

Oh, and how about that bottle of salad dressing in your refrigerator? Check the ingredients and you will almost always find sugar. And really I can’t understand why. Normally on my salad I will simply use olive oil and lemon juice. The last thing I would want to add to a delicious and healthy salad is sugar, in whatever form or quantity. Same with the aforementioned mayonnaise. I usually have to go to Trader Joe’s to buy mayonnaise without sugar which I have tasted and compared with a little Hellman’s or Best Foods’ (both have sugar)  – I can’t really tell them apart – they all taste like mayonnaise. So why do food processors and packagers feel they have to add sugar to everything? Oh and let’s not even mention all the pasta sauces arranged on your supermarket shelves that contain sugar. 

And just today I was shocked to discover that the delicious multigrain snack chips I just brought home from Costco to enjoy with hummus or Vermont cheese, contained sugar. What a shame to discover that these otherwise nutritious chips – with flaxseed, sunflower seed, sesame seed and quinoa supplementing the stone ground corn – were contaminated with sugar. But wait, it says “cane sugar” to distinguish it from other sweeteners like high fructose corn syrup so it must be okay. Yeah, really?

Obviously it’s extremely difficult today to find any processed or packaged food (that’s the key, I guess) without added sugar in it. Genuine foods, unadulterated by added sugar, are mainly in the fresh fruits and vegetables section or in the dried or dehydrated state – dried fruits, beans and so on. But of course, even here we have to beware of GMO foods or foods contaminated with pesticide residue unless we buy bona fide organic foods.

I recently read a piece by the columnist and editor of the New York Times editorial page, David Leonhardt, that provided the impetus for this little article. Mr. Leonhardt had gone for a month without eating any “added sugar”. Why? Well, first he wanted to test the difficulty of finding foods without added sugar – very hard indeed – his guess was that about 75 percent of all packaged foods contain that dreaded ingredient. Also he wanted to test how he felt without that sugar in his diet and to see how he might change his eating habits. Mr. Leonhardt found that avoiding all the added sugar in our packaged and processed food was difficult but rewarding in terms of feeling better and reducing the craving for sweets. He also formed new habits – reading ingredient labels and accordingly striking some foods off his allowed list, adding others and generally eating more healthily, totally changing his breakfast and snack menus. As an example he draws a contrast between the snack crackers Triscuits and Wheat Thins, both made by Nabisco – the former containing simply wheat, oil and sea salt and the latter containing, as he put it, “an ingredient list that evokes high school chemistry class, including added sugars“.

The sugar industry over the years has done a masterful job of promoting its product – “only 18 calories  a teaspoon”, “‘pure’ cane sugar”, “sugar for quick energy” and so on. In the late 1960’s it even paid three Harvard researchers to review several cherry-picked studies which purported to absolve sugar of any responsibility for cardiovascular problems and shift the blame instead onto saturated fats. It also has come up with a dizzying array of euphemistic names for its sweeteners such as “evaporated cane juice “ or “brown rice syrup”. And as noted above it has managed to get sugars into a remarkable three-quarters of all packaged foods in American supermarkets.

I recall vividly as a child in the 1950’s hearing a brilliant gentleman from our church community, Reverend Wesley Gross, later to become my sister Barbara’s father-in-law, deliver a short lecture on the evils of refined sugar, which he labeled “white poison”. Mr. Gross was certainly prescient in warning of the harm that comes from eating sugar, decades before many contemporary nutritionists, doctors, scientists and journalists made a similar case. Appropriately, my sister and her husband Daniel carried on Mr. Gross’s battle against refined sugar as owners and managers of Gross’ Natural Foods in Lancaster, Pennsylvania, a tradition now continued proudly by their daughter Sheila and husband Greg Henkel.

 And exactly what is that harm? Why is sugar bad for us? I finally got around to reading the seminal book on sugar, “Pure, White and Deadly: How Sugar is Killing Us and What We Can Do to Stop It” by British nutritionist John Yudkin, first published in 1972. After sketching its grim agricultural history starting with the cruel slave based production of sugar cane, he describes the detailed experiments he conducted which demonstrated that sugar is indeed related to various diseases, including caries (tooth decay), diabetes, cardiovascular disease and yes, even cancer. Yudkin’s methodology was soundly criticized by US nutritionist Ancel Keys, whose own research claimed that heart disease was caused by consumption of saturated fats. Virtually the entire medical and scientific community then sided with Keys, causing dietary fats to be largely accepted as the major contributor to cardiovascular disease. That pendulum of opinion has only recently swung back to sugar, not saturated fat, being a cause of heart trouble as well as many other health problems.

Many somewhat health conscious people, including myself, were caught up in dietary recommendations illustrated by the US Department of Agriculture’s food guides, which have evolved over the years along with scientific and medical opinion. And those recommendations in the 1980’s were responsible for thousands of people, including myself, eating processed foods that while “fat free” or “low fat” were loaded with sugar. I can clearly recall buying “low fat” brownies and cinnamon rolls from an Entenmann’s bakery outlet in Phoenix, close to my work, and taking them home for the family to eat. I couldn’t believe how good tasting they were, prepared with little or no shortening or butter. But of course they were delicious – they were packed with sugar. But the fact that fat was limited or absent allowed us to think that we were actually doing our bodies a favor.

And interestingly, John Yudkin also tied sugar to a condition with which I have been struggling since my teens – acne, or more specifically, sebaceous acne. Although he admitted that more research is needed, many studies he examined did in fact link sugar to this condition. In my twenties and thirties I endured the shame of occasional sebaceous cysts on my face and neck which often required dermatological surgery from which I still have the scars. I recall one such notable doctor in Boston, Kenneth Arndt MD, who treated me numerous times for this problem. I certainly wish that Dr. Arndt, as well as the many other dermatologists I have consulted over the years, had advised me that sugar could have been the cause of my chronic skin problems. 

While the medical and scientific communities have vacillated about the causes, the fact that our country has a serious obesity and related diabetes and cardiovascular diseaseproblem is unassailable. Presently about two thirds of American adults are overweight, and about half of those, yes, actually one whole third, are classified as obese. Approximately one in ten Americans has Type II diabetes, a huge number, accounting for billions of dollars in medical expenses. And over one third of adults and over half of adults over 60 have metabolic syndrome, a constellation of conditions occurring together which include increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels, that is a precursor to diabetes, heart disease and cancer.

But is sugar really a “poison” as Mr. Gross called it way back in the 1950’s? And is it “deadly” as John Yudkin so boldly asserted in 1973? Well, based upon research described by one of the major journalistic critics of sugar, Gary Taubes, author of “The Case Against Sugar”, the answer is in short, yes. Here’s why – the way we metabolize  fructose in our digestive system is apparently responsible for the build-up of fatty deposits in the liver, followed by insulin resistance, then metabolic syndrome and from there, potential development of diabetes, heart disease, obesity, and yes, even cancer.

And no, becoming overweight and dealing with related conditions is not simply the result of “caloric imbalance”, as many nutritionists would have us believe. One hundred calories of glucose from potatoes or bread is metabolized quite differently than 100 calories of sugar, which is half glucose and half fructose. The fructose from sugar or from high fructose corn syrup is metabolized mostly by the liver while the glucose from sugar and starches is metabolized by every  cell in the body. Therefore consuming sugar (fructose and glucose), means more work for the liver, particularly if it is consumed rapidly, as in a sugared soft drinks or sweet fruit juice. An equivalent amount of fructose consumed by eating several apples also hits the liver but much more slowly. And if lots of fructose hits the liver quickly the liver will convert much of it to fat, eventually inducing insulin resistance. And this is the condition, one part of metabolic syndrome, that leads to obesity, heart disease and type II diabetes.

John Yudkin’s claim that sugar could be responsible for the development of several kinds of cancer was dismissed as a stretch of the data at the time. Yet, recent surveys and research do in fact support sugar being a cause of cancer. This occurs because insulin resistance causes the secretion of more insulin. And this additional insulin, plus a related hormone called “insulin-like growth factor”, according to Taubes, actually promotes tumor growth. How? Without the additional insulin and its accompanying “growth-factor” hormone pushing them to absorb more and more blood sugar, most pre-cancerous cells would never develop the mutations that turn them into malignant tumors. So if it’s sugar that causes insulin resistance, then the conclusion is hard to avoid that sugar causes cancer — some cancers at least, mainly those of breast and colon. In Taubes’ words – “The connection between obesity, diabetes and cancer was first reported in 2004 in large population studies by researchers from the World Health Organization’s International Agency for Research on Cancer. It is not controversial. What it means is that you are more likely to get cancer if you’re obese or diabetic than if you’re not, and you’re more likely to get cancer if you have metabolic syndrome than if you don’t. “

Another of the notable warriors against sugar today is Dr. Robert Lustig. He continues his battle with a variety of videos about sugar, including a Ted Talk, and has written polemics about its harm. His YouTube video, “Sugar: the Bitter Truth”, has been viewed millions of times. And Dr. Lustig has also provided the introduction for the recent  edition of John Yudkin’s book that I just finished. His own best selling book “Fat Chance: The Hidden Truth About Sugar, Obesity and Disease” joins the Taubes book as the two most popular and authoritative accounts of the dangers of sugar and its relationship to obesity and disease.

It is very important to note that these sobering truths about sugar do not apply to sugar found naturally in fruits and vegetables. Even though the naturally occurring sugar in an apple or orange contains the same ratio of fructose and glucose as simple refined table sugar, it is wrapped in water, fiber and a variety of other nutrients so the fructose component is metabolized in the liver and the glucose in the rest of the body, much more slowly. I don’t think that anybody ever got fat from eating too many bananas, although they contain significant sugar. Nor has anyone developed diabetes from eating too many oranges and tangerines. And to my knowledge apples have never rotted anyone’s teeth.

As if all the above problems with sugar are not enough, sugar may also be addictive. We’ve all had or at least heard of that proverbial “sweet tooth” when that one can of Coke wasn’t quite enough, one cookie has to be followed by another and another until they’re gone or one Reese’s peanut butter cup creates a desire for many more. Or that leftover Halloween candy gets quickly eaten up. There definitely is something real in that “sugar high” that feels so good when you finish off that ice cold Sprite. Yes, all that sugar or the more concentrated high fructose corn syrup from that sugary drink not only gives the liver a jolt but the brain as well, by activating the pleasure center and dumping some of that feel-good neurotransmitter, dopamine. And it seems that after a meal we often crave something sweet – thus the tradition and habit of dessert after a meal. 

But the issue of whether sugar is truly additive is still being debated. Certainly it is not in the class of truly addictive drugs like cocaine or heroin. And thankfully whatever addictive powers it does exert on us can be thrown off far more readily than that of real drugs. The desire for something sweet, more a craving than an addiction, can be controlled and ultimately erased by employing a little will power. And this craving for sugar is not dissimilar to the general craving for carbohydrates generally that many of us possess or have experienced that is also diminished and controlled by adherence to a low carbohydrate diet.

So where are we as a country, as a population, on the sugar issue? Per capita consumption of sugar in the United States, at approximately 100 pounds per year, continues to be startlingly well above the level of the other major sugar consuming countries. And interestingly the United States also leads the world’s developed countries in obesity. Shouldn’t this tell us something about the relationship of sugar to obesity? Actually if you compared a table of the most obese developed countries to the table below, there will be a surprisingly accurate correspondence to the rate of sugar consumption to the rate of obesity.

 

And also, if we take a look at the graph of the growth of sugar consumption in the United States during the last couple of centuries, I am sure we could superimpose a graph of the growth of obesity or the growth of the incidence of Type II diabetes over the same time period and again obtain a reasonably accurate correspondence.

 

Why are we a leader in these dubious categories? One reason has to be, as described early in this article, the inclusion of “added sugar” in so very many of the foods we regularly purchase at the super market and consume in the home. The other has to be the huge consumption of sugary beverages in the US. Stop at any convenience shop and take a look at literally walls of shelves of sugary carbonated beverages and sugary so-called sports drinks. And incidentally, Gatorade or Powerade or any of the other sports beverages, which are consumed by many teenagers as healthy alternatives, are as full of sugar as most other sugared beverages. And the sugar contest of these popular beverages is truly astonishing, ranging a little above or below 10 teaspoons per 12 ounce container.

So how can we reduce the sugar in our diets and limit the diseases that are obviously caused by sugar. One way is to tax sugary beverages to reduce their consumption but these efforts have been beaten down by the beverage corporations and the sugar industry and their well paid lobbyists. And, need I mention it – our Congress has been totally unresponsive to the public health threat posed by sugar. So it is up to each of us to dramatically reduce the amount of sugar in our diets and most who have done so, like Times columnist Leonhardt, mentioned earlier in this article, have been rewarded by significantly improved weight control and vastly improved overall health.

So was Mr Gross right decades ago when he called sugar “white poison” or was the term too cynical, too hyperbolic or too pejorative? Absolutely not. As shown above, he was incredibly prescient and, along with Yudkin, Taubes and Lustig, he was right on the money. If a “poison”, defined in my Apple computer dictionary is “a substance that is capable of causing the illness or death of a living organism when introduced or absorbed”, refined sugar definitely meets that definition.

And one final note – if the dangerous qualities of sugar and what it does to our waistlines and our metabolic systems isn’t enough, one might also consider the cruel history of its agriculture and harvesting to be enough alone to reject it. Slavery and the slave trade were strongly linked to the sugar industry in its infancy as illustrated in a current New York Times article and conditions today relating to its production aren’t a whole lot better.