For some—let me add crazy—reason the concept that sugar leads to type 2 diabetes has long been controversial. I suspect the food industry (which pushes a whole lot of sugar!) is partly responsible for perpetuating this myth, but it looks like we may be able to finally put it to rest. A recent study published in the Public Library of Science ONE journal found that dietary sugar leads to diabetes even in perfectly healthy people.
The researchers examined data from 175 countries over ten years. They found that increased sugar in the food supply was linked to higher diabetes rates, independent of a number of factors also known to be linked to diabetes, especially obesity. “We’re not diminishing the importance of obesity at all, but these data suggest that at a population level there are additional factors that contribute to diabetes risk besides obesity and total calorie intake, and that sugar appears to play a prominent role.”
In the study, more sugar was linked to more diabetes. For each additional 150 calories of sugar (the amount found in one 12-counce can of soda) consumed per person daily, the prevalence of diabetes in the entire population increased by one percent, even after controlling for obesity, physical activity, calories from different foods (as an example, 150 calories of any type of food only raised diabetes prevalence by 0.1%—ten times less than sugar), as well as economic and social factors. A calorie is not just a calorie, despite what we have long been taught.
This study was an epidemiogical study, which determines associations rather than proves causation. But this study was very well designed and strongly suggests that sugar does, indeed, cause diabetes. “In medicine, we rely on the postulates of Sir Austin Bradford Hill to examine associations to infer causation, as we did with smoking. You expose the subject to an agent, you get a disease; you take the agent away, the disease gets better; you re-expose and the disease gets worse again. This study satisfies those criteria, and places sugar front and center,” stated lead researcher Robert Lustig, MD.
Finally the sugar debate may be coming to an end. “This has been a source of controversy forever. It’s been very, very difficult to separate sugar from the calories it provides. This work is carefully done, it’s interesting, and it deserves attention,” said Marion Nestle, PhD, a nutrition professor at New York University who was not involved in the study.
Listen folks, sugar breaks down into glucose and fructose. Glucose gets into the bloodstream and raises blood sugar levels. Fructose is processed in the liver and can trigger insulin resistance. When sugar is constantly consumed in excess amounts, it leads to diabetes or at least prediabetes (which affects 79 million people in the United States, many of them unaware of it).
In my mind, and in the mind of many experts, there is no question. Sugar has got to go. Dr. Nestle agrees, “How much circumstantial evidence do you need before you take action? At this point we have enough circumstantial evidence to advise people to keep their sugar a lot lower than it normally is.” Now let’s hope everyone hears this message.