Gary Taubes - 'The Case Against Sugar'

this by the way I gave a talk I gave in San Antonio Texas right around Halloween and this is a day of the dead sugar head that they gave me as a gift and I took home and photographed it myself and I still quite fight kind of gives away my bias but anyway so thank you I'm still under the weather so I apologize in advance and this is gonna be a little repetitive because I'm gonna cover some of the ground I covered this morning because it's relevant to the sugar story and as you guys know I have a predilection for historical historic approaches and I like epigraphs um this from Peter Medawar Nobel laureate who said scientific theories begin if you like his stories and the purpose of the critical or rectifying episode in scientific reasoning is precisely to find out whether or not these stories or stories about real life so what I'm going to tell you tonight is a story and then I'm also going to explain why the critical rectifying episode in scientific reasoning never actually happened so even though I'm gonna implicate sugar and all the chronic diseases that beset us and I'm hoping to explain it's wrong I'm also going to say I don't know the case that I'm presenting is actually true because the stories the actually said they're the the the research that could be definitive has never been done in fact when I wrote this book the case against sugar I thought I'm gonna be pilloried by half the community because I don't believe the calorie is a calorie and I'm gonna be pilloried by my allies because I'm writing a book called the Kasich and sugar and saying I don't think we actually have enough evidence to indict sugar we just have our we don't have enough to convict we only have enough to indict um this Claude Bernard was a great French physiologist who arguably inaugurated the era of experimental medicine and he did it in this book in 1865 and he made a point that I despite having been writing about science in the 1960s I never really thought about he said all human knowledge is limb excuse me 1980s argument knowledge is limited to working back from observed effects to their cause often when we talked about chronic diseases and possible toxic aspects of our diets and I wanted the arguments always make to people as well what you know let's say for instance that X is bad for us what disease is X causing what is the observation we're trying to explain because if you don't know what that observation is if you don't have an epidemic that you're trying to explain or an increased risk of disease or a serious risk of disease then we're not really following the scientific method at all the way science works is you see something usually it's something that is unusual that you don't expect to see that your beliefs about the universe don't explain and then you go off set off trying to explain it and by explaining if you try to establish its cause so the observed effect in this case and we're trying to explain the case against sugar it's like if a crime has been committed the crime that we're trying to explain our worldwide epidemics of obesity diabetes and related chronic diseases that follow a nutrition transition from traditional diets and lifestyles to Western diets and lifestyle and we'll talk about this anywhere in the world that we'd go we find a population and when they ate their indigenous native diets they did not have these epidemic levels of obesity and diabetes and then they shifted and they did that's what we're trying to explain and the thesis of this story is that its caloric sweeteners and by that I mean specifically sucrose which is a white stuff you can be put in our coffee and high fructose syrups in the u.s. it's high fructose corn syrup are the cause okay so one of the key aspects if you have an epidemic you want to go back to the origins of the epidemic to understand that right if you just step in Midway you don't know where it came from like even with Ebola you want to find the animals that are transmitting the epidemic because if you could do that you could solve the problem and we can do that in this case that's what's so fascinating so this is a story this fellow Elliot Joslin was the leading diabetes specialist in the United States to the mid half of the 20th century his diabetes research center merged into the Harvard universe and became one of the major diabetes research centers in the world and in 1898 Johnson was a young man he just finished medical school with this pathologist Reginald Fitz he was working in Massachusetts General Hospital which is a major urban hospital in Massachusetts and he wanted to figure out what was happening with diabetes how to cure it and how to treat it so he went through the medical records at Mass General for 74 years I believe it was 4,000 records they went through at hand by hand looking for 48,000 he's made 48,000 inpatient records over 74 years looking for every case of diabetes so they could see how it was handled what the de new mama was what was treated and in 48 thousand inpatient records over the course of 74 years 1824 was when Mass General opened he came up with 172 cases of diabetes okay total and in some of these years it's one in every 280 patients today in the United States as we'll discuss diabetes is in about one every eleven people and in some hospital systems it's one in every four like the veteran administration hospital one in four even more than one in four the patients are diabetic in this case was one in every 280 patients and as you could see from these numbers from his paper there were years from 1824 to 1840 where there were no cases of diabetes and as the numbers went up and as the years went by and who are larger and more and more cases showed up and a larger and larger percentage of cases showed up and what's interesting is Jocelyn he noticed this Jocelyn and fits within the past 13 years as many cases of diabetes who admitted to the hospitals in the previous 61 years and the percent in the past 13 years of proportion the total number of hospital entries has increased fourfold but he didn't see it as the beginning of an epidemic he actually thought this was a good sign he thought more and more people when presenting with diabetes were willing to go off to the hospital to be treated and that's what they were seeing and in fact in the 19th century if you had a serious disease staying away from a doctor was very good advice okay may still be but it certainly wasn't in the 19th century so often and the wealthy the the hospitals tended to be more for the impoverished people the wealthy tended to have their own hospitals and if the wealthy were the ones getting diabetes they would not be treated in the hospital so there are ways to explain this other than increases in diabetes prevalence but what he was seeing was being seen elsewhere as well so it's call about Mass General Hospital's you can actually contact them archivists and you could contact the hospital and ask them to go through those same records which they did for me to confirm that what jocelyn said was true and Pennsylvania Hospital in Philadelphia Pennsylvania Hospital is the oldest hospital in Philadelphia Pennsylvania and it too has archivist said I asked them to do this exercise and they had records back to 1867 and you could see the same emergence of the epidemic okay in years from 1867 to about 1910 there are years with zero cases of diabetes in the major urban hospital center and then it explodes post 1900 so the question is what's going on and what's interesting is beginning in 1921 when Jocelyn addresses now he's a mature physician he's considered already the leading diabetes specialist and now he's beginning to use the word epidemic to describe and he says in 1900 the death rate from diabetes in the registration area of the US was 10 per hundred thousand and by 1915 was 18 and the same period in Boston arose from 14 to 26 and now we're talking to half a million diabetics in the US here are those same statistics as accumulated in a chart from the head of the New York City Public Health Department a man named Haven Emerson who published this paper in 1921 and you can see in some American cities you've got a doubling of deaths from diabetes in the course of 20 years 21 years and then when he went back to the Civil War which ended in the u.s. in the late 1860's in some cases or increase in diabetes death by 15 fold major American cities so it was Jocelyn police said they're entirely too many diabetic patients in the country statistics for the last 30 years so so great an increase in number then less this were in part explained by a better recognition of the disease which is always possible the outlook for the future would be startling so now we'll just flash forward to our future his future which is our present and we have today in America we've got 30 million Americans with diabetes so we go from one in every 280 patients to one in every 11 Americans and worldwide I brought up Margaret Chan's talk this morning I gave the diet obesity numbers these are the diabetes numbers it's one of the biggest global health crises of the 21st century and w-h-o estimates suggest it's increased fourfold since 1980 and that the actual global prevalence of diabetes has doubled since 1980 so this is the observation for which we need an explanation this is what we're looking for the cause of and here's that same observation the Navajo Indian you can find a chart like this and virtually every population where you have trends the Navajos a Native American tribe here you can see diabetes incidents from 1956 where it's practically zero up through 1989 and here's the same observation in Japan from 1950 to 2004 and this is a number in the US population with diagnosed diabetes from 1958 2009 that's a 600 percent increase in prevalence and again if this had been any other chronic or infectious disease you'd have these men and white coats walking through every hallway in the country with like biomat you know um biohazard material trying to take measurements to figure out what's going on in this case we don't really care so we have similar patterns observed in the Inuit and the First Nations people Polynesians Micronesians Melanesians the Aboriginal population here and my orys in populations through every major continent and in short and effectively every population in the world so something about the Western diet is causing this pandemic Western diet and lifestyle it could be people start using cars and they become sedentary it could be that they eat too much we'll discuss it so here are the obvious questions what's the cause of this pandemic okay that's what we want to know because in order to understand how to treat and prevent it we have to know the cause what's the environmental trigger ie the agent so for instance we've heard a lot about ultra processed food for instance may be able to process food it's the problem one of my problems is something like ultra processed food is it's a kind of an anti scientific explanation it's like the miasma theory of infectious disease back in the 19th and 18th century people used to think that the reason people got sick when they lived near swamps and in lowlands and near rivers and their water still water is because of the bad air that came off the water the miasma that came off the water that made them sick and it was kind of a useful hypothesis in the sense that the rich people knew to live away from the water and up on hills and the poor people were stuck dying from these horrible diseases and you had to identify not just the vectors of the disease which were the rats or the mice or the mosquitoes but the actual agents of the disease the viruses or the bacteria and then you can really make progress against them without that you don't know what it is and ultra-processed food to me is a kind of miasma theory it's like ok well we we do if we have a food with five more more than five ingredients we're gonna say you know this is the problem with obesity and diabetes but we don't get any more specific we don't know what to remove so what are the aspect of diet or lifestyles to blame why aren't we doing everything we can possibly to find out I mean why aren't we trying to figure this out where are the I have to go from here on Thursday I have to be in Princeton New Jersey for meeting of the Robert Wood Johnson Foundation which has invested a billion dollars in childhood obesity and nowhere in the seminar for this entire day where they have 40 odd authorities on obesity gathered do they talk about the we and do we understand the aegeon to this disease do we know what's really causing it so we know what we have to stop people from eating or doing so why aren't we questioning our assumptions and why is no one being held accountable other than the victims and maybe the food industry and another way to phrase that is why are no heads rolling why are the same people have been in charge throughout this epidemic still in charge when you have fired them by now by the time you got to like 300% increases I mean can you turn off the camera for a second sometimes I like Trump's attitude go back to filming okay why not the question why not the answer why not is we think we know the answer and we discussed this this morning okay type-2 diabetes is caused by obesity or excess fat accumulation and excess fat accumulation is caused by overconsumption that's the belief that's why nobody's looking these are like I said Newton's laws oh then diabetes epidemics are certainly associated with obesity epidemics we've had them along with the diabetes and they're associated with obesity epidemics and children too so it could be what's happening in childhood drives what's happening in our hood and then you get this other complicated way of looking at the idea is that obesity and diabetes are multifactorial complex diseases this is actually a simple diagram compared to the one I saw at the University of Sydney on Thursday when I lectured where they had it's about a factor of 50 more complicated with all the arrows so if you say the disease is a multifactorial complex disease that excuses your inability to determine a cause okay it's a rationale of course we didn't figure it out because it's just too hard now there are too many factors it's not simple you'll hear this over and it's not even one disease there's now this theory that like cancer there are many many different types of obesity so everyone needs a different approach and the problem with that thinking is there are some questions that do have simple answers so if I hit myself over the head with a hammer my body's worse phonce is multifactorial and complex okay there's that a lot of mechanisms that kick in both in the initial contact and in the healing period but if I don't want to suffer the pain and agony of the hammer hit this simple solution is removed the hammer but we have to know what that that's the hammer that caused the problem and it's one of the reasons where these people get confused as soon as they start thinking multifactorial and complex they assume that the environmental trigger whatever it is in the diet lifestyle that's doing it must also be multifactorial so I grew up in the physics community and physics they believe in Occam's razor so never multiply hypotheses beyond the sassa T this is how Einstein put it everything in it was paraphrased said everything should be made as simple as possible but no simpler so the idea is it doesn't mean these simple hypothesis is necessarily the correct hypothesis but you start with the simple hypothesis because if you don't you'll never make progress and once you've come up with evidence that the simple hypothesis is wrong then you go to another simple hypothesis or you complicate the simple hypothesis to account for the evidence so it's like if we're trying if there's a serial murderer operating in Brisbane and there's 15 murders that all happen with very similar you know the weapon seems to be the same the modus operandi seems to be the same our simple hypothesis is it's one murderer so we arrest John Doe for the murder because he seems to be there's a lot of evidence pointing to him and then there's three other murders that occur that are identical and now we have to complicate our hypothesis which is either we have the wrong perpetrator and it's not John Doe or there's a copycat killer and there are two so now we have a more complex hypothesis but you start with a simple one and in this case like the serial murder example you have the same epidemics appearing everywhere let's assume it's the same cause unless we have to complicate it so the simpler possible hypothesis is a single agent a single item of our Western diet lifestyle and I'm just going to ask the question what about sugars possible that is sugar okay and what's interesting is sugar in the sugar industry if you look at us in the US particularly the sugar consumption exploded in the 19th century pretty much an association with the diabetes epidemic so in the early 1800s we were consuming about five pounds of sugar per capita and in the 1840s you have the invention of the candy industry the chocolate industry in the ice-cream industry all in the 1840s chocolate courtesy of the Lindt Brothers in Switzerland which still makes some of the best chocolate out there 1870s 1880s comes a softer industry an explosion of sugar consumption and by the end of the century we're eating about 90 pounds per capita of sugar and meanwhile on all these other populations around the world sugar and white flour was always the first signs of a nutrition transition so sugar is at the scene of the crime not enough to implicate it but it's the tene of the crime and the interesting thing of my research was it used to be the obvious suspect back when people became diabetes specialist because diabetes became a disease that was common enough to require a specialist they started saying look the consumption that Frederick Allen was a leading authority on diabetes Priya Lee at Joslin and in his textbook studies concerning glycosuria in diabetes says the consumption of sugar was undoubtedly increasing it's generally recognized that diabetes is increasing and to a considerable extent incidence is greatest among the races in the classes of society that consume the most sugar and in particular he was thinking in 1907 the British Medical Association had a meeting about diabetes in the tropics is that a diabetes epidemic in India that they were mostly concerned with although the British again had missionary physicians all over the world there were doctors in Africa a silicon urban wealthy urban centers we have epidemics of diabetes and in poor rural centers we do not and there's a lot of things the wealthy Indians and the wealthy Africans did that the poor Indians and the poor Africans did not they were sedentary there was even a theory that maybe because they tend to be you know lawyers and have to use their brain more than something about using your intellect that raises a risk of diabetes but the obvious thing was sugar consumption and they knew it back then so it's apparent that rises and falls in the sugar consumption are followed with fair regularity by similar rises and falls and the death rates from diabetes this is Haven Emerson was a head of the New York City Department of Public Health he taught at the public health school of Columbia University and Louise Larimore was his colleague at Columbia and they made this argument in 1924 paper where the top of these charts are death rates from diabetes and at the bottom you have sugar consumption and the dips here and here are during World War one and you could see but again during Wars and rationing a lot of things change so it's an association it doesn't tell you it's correlation but it's an interesting association again it tells you not only with sugar at the scene of the crime but when I left the scene in the crime the crime didn't happen the problem with this argument it's Jocelyn didn't like it okay one thing I've learned about medicine and new people have begun to learn over the years is that medicine is determined what people believe is determined by authority figures it's not like other Sciences where people are thought to question authority and question authority and then you get nothing brings more joy than the proving that your authority figures are wrong in medicine if the leading the god of the subject tells you it's true you kind of believe it's true and then you move on to memorizing something else so the first reason you didn't like it is a Japanese ate a lot of carbs and they had little diabetes and Jocelyn believed that there was no difference between sugar and other carbohydrates apples it didn't matter it was all the same to Jocelyn I don't know if he was never taught biochemistry or he forgot it he may never have been taught it at that period in time so the Japanese had very little diabetes here and they ate a lot of rice and this has always been an argument fifty years later would be against the idea that carbohydrates are the argument for the idea that dietary fat causes heart disease because populations that ate a lot of carbs like the Japanese a very little dietary fat what Johnson didn't know like I said is that sugar and other carbohydrates are different other starches and grains break down to glucose okay and sugar is a combination of glucose and fructose 5050 they're bonded together and sucrose although when you consume sucrose or and sugary beverages that bond is broken very quickly and sugary beverages up is probably broken before you even consume and high fructose corn syrup came in in a big way in 1978 and it was 45% glucose and 55% fructose and it was designed to with the fructose content that would taste exactly like sugar when used in coca-cola that's what the Corn Refiners tried to achieve and they did for the most part and those are monomers they're not joined but as I said the sucrose molecules by the time you consume them have been broken up also if you actually look at the sugar consumption of the Japanese and diabetes back when their diabetes rates were exceedingly low which happened to be turning their war years or right after their war years when they were recovering from the devastation of the war and the atom bombs their sugar consumption was also up so I had Jocelyn bothered to understand that sugar was different from other carbohydrates who would have concluded that this evidence does not refute the hypothesis sugar isn't at the scene of the crime and the crime isn't being committed even if some other carbohydrate is number two sugar was valuable for hypoglycemic episodes caused by insulin and this was something the leading British researcher Harold Hemsworth also who was a he was a leading authority and diabetes was thirty years old at the time there weren't a lot of leading authorities on diabetes but he also found this interesting that if you have a hypoglycemic in an incident from poorly timed insulin doses and virtually all insulin doses were poorly timed back then beginning of a lot of experience with it you can bail people out by giving them cash the orange juice and this was a good thing so therefore sugar was a good thing and most diabetes is caused by getting fat this is part of our Newton's laws of diabetes which is caused by eating too much or exercising too little so we know the cause of diabetes is so closely associated with getting fat we don't have to link it to sugar we've got our suspect so diabetes is largely a penalty of obesity as Joslyn said and the greater the obesity the more likely is nature to enforce it with an excess of fat diabetes begins and from an excess of fat diabetics die so why do we get fat this is what we discussed this morning joseline believed that obesity was an energy balance disorder caused by the overconsumption of calories hence this phrase at calories of calories of calorie thermodynamically a calorie of protein is identical in the human body to a calorie of carbs current calorie of fat so it doesn't make any difference and in my book I refer to this as the gift that keeps on giving okay because if obesity is caused by eating too much and diabetes is caused by being obese there's nothing special about any calories you can't target sugar the way I did because the worst you could say about sugar is it tastes too good and if it tastes too good and we over consume and well that's not the sugars fault and just need less of it drink less of it or eat less broccoli to balance the sugar or is the soda industry tried to do just exercise the calories away so this idea that that obesity is an energy balance disorder which implies a calories of calories a calorie was an incredible boon to the sugar industry and you'll see as people started attacking the sugar industry this is what they reply and you could see this was a few years ago the city of San Francisco across the bay from me in Oakland passed a law that would require a very benign label on sugary beverages saying they were associated with obesity and diabetes and the sugar industry fought it and the city of San Francisco brought in in the appeal as their scientific expert the greatest nutritionist in the world Walter Willett from Harvard University who's been the bane of my existence and in Walters expert testimony he says obesity arises as a result of an energy imbalance between calories consumed and calories expended creating an energy surplus and a state of positive energy balance which in turn results in excess body weight over time and the city of San Francisco loses the appeal because the judge in effect says look if obesity's caused by caloric excess and you cannot blame sugar and in fact Willard has a study out of Harvard that says french fries are more fattening than sugar but they say not people don't eat that much french fries and the jury doesn't buy it and neither does a judge in the 1950s the sugar industry was embracing this idea and it wasn't you can't blame them this was nutritional thinking you're reducing diet calls for sugar sure or sugar for energy and remember three teaspoons of Domino sugar contains fewer calories in your egg which is true I mean I don't know where they get these comparisons from but smart to say so that pushing sugar as a as a and this was by the way this was in response to the 1950s saw the appearance of artificial sweeteners used in products that were targeted for people wanted to lose weight up until the 1950s the only use of these were for diabetics who were trying to avoid sugar for the obvious reasons by the 1950s suddenly the artificial sweetener industry comes in the the artifice of sodas with sweetened by artificial sweeteners are booming and the sugar industry has to fight back and they fight back by saying you know look at this if sugar is so fattening I love this one how some so many kids are so thin mmm times change the fact is if you can't see taking more food than your body needs you'll probably get fat if you eat a balanced diet in moderation you probably won't sugar in moderation as a place and a balanced diet there's nothing special about it so sugar is not the cause of obesity and this is a sugar industry Association website in the United States consuming more food as well causes obesity not sugar if you want to lose weight you'll need to cut calories or increase your activity nothing was so beneficial to any industry as this energy balance idea was to the sugar industry and it still is in other words are no bad foods only bad behaviors and to catch with the energy balance calories of calorie thinking as I mentioned this morning it's tautological so here's Willits statement about obesity arises the result of an energy imbalance and here's the equivalent and wealth wealth arises as a result of a money imbalance and here's the equivalent in climate change I could be lecturing about climate change serious problem climate change arises as a result of a heat imbalance between energy entering the atmosphere and energy leaving it creating a heat surplus in a state of positive heat balance which in turn results in excess heat and climate change over time same logic okay except that leaves out billions of dollars in research into what actually in the climate may if you be a heat trapping problem not an heat imbalance problem just as we described obesity may be a fat trapping so if this kind of explanation is absurd for wealth and climate change why is it the accepted explanation for obesity and as we talked about because it was the first explanation for obesity and it took away from the obese people their excuse that obese might be a hormonal problem then people saw that as an excuse for obese people to not do what lean people do which is eaten moderation and exercise so the alternative hypothesis physiology and medicine post 1920 consuming sugar has unique hormonal metabolic effects that favor fat accumulation and insulin dysregulation okay so this is empty calories versus a metabolic hormonal effect if sugar if obesity is an energy balance is sort of the worst we can say about is it's empty calories okay it brings energy to the diet and it's empty of vitamins minerals protein anything else you might need and one of the belief systems if you consume a lot of sugar then you have to over consume everything else to get the vitamins and minerals you need so that's the empty calories this metabolic hormonal effect this is how Robert Lustig at UCSF was kind of the leading proponent of the sugar theory he gets a lot of credit for pushing this when it was very unpopular 100 calories of sugar 50/50 fructose and glucose asthma stabilized differently from 100 calories of glucose alone which is metabolized differently from 100 calories of protein or a hundred calories of fat the hormonal responses are entirely different entirely different why would you expect the response of the body to be identical just because they have the same calories so Lustig says that um one thing is isocaloric but is it ISO metabolic and it certainly isn't so we went through these slides this morning to insulin we find out by the 1960s it's the principal regulator of fat metabolism release of fatty acids requires only the negative stimulus of insulin deficiency and in the 1960s researchers start getting interested in this again Jocelyn manages to sort of shut down the argument from 1930 through 1960s but in the 1960s researchers start paying attention to what we now call metabolic syndrome actually it begins in the 1950s so we have two competing hypotheses in the 1960s American researchers led by Ansel keys who actually start beginning in the 1950s start asking this question what's the cause of heart disease in America there appears to be a heart disease epidemic there may not have been it may have been going on for decades but there appears to be one that's post-world War two and as I said this morning the question you ask in science determines the answer you get so if you ask the question what's the cause of heart disease in America and you notice that people with heart disease have atherosclerosis and they have cholesterol and their arteries in the a throat and the arthrosis Florek plaques and you start identifying cholesterol as a causative factor you could come to the hypothesis that cholesterol is a problem worldwide british researchers who are have the british colonies and the missionary hospitals in colonial hospitals all around the world are noticing these epidemics of obesity and diabetes so they ask a different question what could be the cause of obesity and diabetes epidemics worldwide and any pop every population around the world and also heart disease in cancer because these are appearing and gouts peering and dental caries is appearing and arthritis is appearing and all these diseases that became known as Western diseases and they want to know what the answer is to that what's causing that what's causing the observation we're interested in and if we figure that out it might also explain along the way what's causing heart disease in the u.s. because heart disease is part of this cluster of chronic diseases so you end up with these competing hypotheses the British are saying it's sugar and refined grains and the Americans are saying it's cholesterol and dietary fat and the British are led by John Yadkin John Watkins a young British biochemist physician is working he actually founded the first dedicated nutrition department in the UK his graduate he's a smart guy his PhD thesis was later used by the French biochemist Francois Jaco for the basis of the work that one Jacobi the Nobel Prize in deco gave him credit in his Nobel Prize speech and Yadkin just says look if we're looking for dietary cause of some of the ills of civilization we should look at the most significant change in man's diet the most significant change in sugar consumption and as early as 1964 he's publishing articles in The Lancet sayin national levels of consumption of fat sugar are similar but statistics relating fat and heart disease or diabetes and different populations may therefore Express only an indirect relationship and the causal relationship may be with sugar and he's focusing on sugar and he's on the hormonal and enzymatic effect of sugar and he's making this point as he does later in his book sweet and dangerous then when people are at high risk of heart disease they don't just have elevated cholesterol or elevated LDL cholesterol in fact many of them don't even have elevated LDL cholesterol they have a cluster of metabolic abnormalities something seems to be going wrong throughout their entire bodies manifesting itself in a host of different systems and again this thinking became metabolic syndrome this is the origins of the metabolic syndrome thinking and the problem with this hypothesis is an soaky's didn't like it and Ancel Keys was now the god of nutrition in the United States and he was a proponent of the dietary fat hypothesis this is the first problem with this hypothesis okay and in 1972 71 this started as a letter that Keyes wrote to his colleagues ridiculing Yadkin and his hypothesis and the evidence and then it was published in 1972 and he says nine the widely publicized theory that sucrose in the diet is a major factor in the development of coronary heart disease has been examined this theory is not supported by acceptable clinical epidemiological theoretical experiment though evidence it's been claimed that the theory is supported by international statistics by the time trend of the incidence rate by comparison of dietary habits and by experiments not one of these claims is justified by the actual episode and in fact Jocelyn made it up the other problem with this argument is that the sugar Association didn't like and the sugar Association was a lobbying and research arm of the sugar industry and they had a real problem first of all they were being attacked they were they were being their competition was the artificial sweetener so that a direct challenge with the artificial sweetener industries people started moving artificial sweetener non-caloric sweeteners thinking they could lose weight and so they were fighting that they managed to get the artificial sweetener cyclamate ban through research they funded and now they had people like Yadkin and others attacking them and as I said this morning I have to be completely honest when you give all this information some of the people attacking them look like quacks the founder of the natural food organic food industry whose name is going to escape me at the moment wrote a book in 1967 not only saying sugar was response for every chronic disease for mental illness for criminal behavior he blamed Hitler and Napoleon on their sweet tooth's okay so you read this and you assume that everyone going after sugar I don't blame the sugar industry they had an interesting position 99% of the community thought dietary fat caused heart disease and Yadkin was saying it was sugar and 99% of the community thought obesity was an energy balance disorder including Yadkin so what level of the sugar industry supposed to take seriously the small percentage of the population of the research population that same sugar is a problem and of course they'll say well we have stockholders we have to respect and all that but I don't actually blame them for what they did in confronting our critics as Jack Tatum the sugar Association the true friend this was to a meeting of their board and confronting our critics we tries never to lose sight of the fact that no confirmed scientific evidence laying sugar to the death-dealing diseases this crucial point is a lifeblood of the Association and it was the lifeblood of the Association and it was interesting sugar industry acted like that the backhoe industry but they didn't the tobacco industry had to convince people that the experts didn't know what they were talking about the sugar industry had to convince them that they did okay they just had to say this is what the experts believe and if the experts are right which we believe that our sugar is harmless and that's what they did they put out a statement they put out a report they hired a team of researchers under Ancel Keys at heart excuse me Fred stair at Harvard and arm stair recruited many of Keyes's colleagues and they all believe dietary fat was a problem then they put together a report called sugar and the man it was 130 pages it's published as a supplement in the journal and it went through every possible disease that sugar could cause and blame them all on fad because everyone they had hired to be an author thought that was a cause and then they put out a press release they distributed something like 25,000 of these reports and one of the reports the reports also went to the Federation of American societies for Experimental Biology recognized as safe' so what happened is in a lot of artificial food industry artificial additives came along in the night from in the beginning of the 20th century and beginning in the 1950s people started suspecting that they some of them might be carcinogenic so the FDA was charged with determining whether or not these wore and some of them were questionable enough that they were put together they put together this panel that examined whether they had grass status generally recognized as safe and the sugar industry helped this panel when these researchers were sugar in the diet man they gave him this thing and the panel decided that sugar should genuinely be recognized as safe they also said basically it's too big to fail if we say it shouldn't be generally recognized as safe the food industry is pick your scatological terminology and they weren't going to say that so they published in 1976 their first report exonerating sugar or claiming that sugar appeared had grass status and then they followed up in 1986 with the secondary report and if this is the FDA conclusion no conclusive evidence on sugars this is how they had to phrase it this was written into their bylaws no conclusive evidence on sugars demonstrates a hazard to the general public when sugars are consumed at the levels that are now current okay raises the question one of the current levels what's interesting is the FDA bureaucrats who did this assessment the head of this assessment then went on to work for the corner refiners not that that's relevant did been upon themselves to do their own assessment of how much Americans were consuming at the time and the FDA assessment for 1986 was 40 pounds per person per year 40 pounds per capita remember that document I showed you the chart I showed you had us at 90 pounds by the turn of the century when the FDA made that assessment the USDA assessment was 75 pounds per year you have to know the difference between that document I showed what 290 pounds was how much the sugar industry makes available and then what the FDA and the USDA do the US Department of Agriculture's they have a calculation of how much sugar that's made available doesn't actually get eaten how much is wasted how much goes into pet food how much goes to paint in the Payne industry so they end up with about they cut off about 2/3 of it but they had their estimate and only double and by 2016 we were supposedly consuming about 90 pounds so even if FDA was right that it was generally recognized as safe at 40 pounds the question is would it be safe at twice that level the FDA assessment handed by bylaws again was used by every government agency in the late 1980s as the US government decided they had done a sufficient job of demonstrating that dietary fat caused heart disease they started a public relations campaign that's how the administrators described it to convince all Americans that saturated fat would kill them and they should eat less of it and they put out a series of major reports these were two of the largest the Surgeon General's report on nutrition and health and the NI in a tional Academy of Sciences Dian Health they're both about 900 pages they were both front-page news in the newspapers if you live to this period which I did every time one of these reports came out he thought oh my god it's true I'll never have an avocado or a piece of butter again and you didn't realize is the chapters and relevant chapters in these documents are all written by the same six or eight researchers who just moved from agency to agency is necessary to write so it was the opinion of six or eight people and there were counter opinions here's a major conclusion from the Surgeon General's version overconsumption of certain dietary components is now a major concern for Americans while many food factors are involved chief among them is this portion of consumption of high foods high in fats often at the expense of foods high in complex carbs and fiber such as vegetables fruits whole grains it may be more conducive to health one of the unintended consequences of this so we implicate fat and we give sugar a free pass they never said you could eat as much sugar as you wanted the US Dietary Guidelines said avoid consuming too much sugar remember we talked about the tautology this morning that's involved with phrases like too much or excess how do you know you're consuming too much you're getting fatter you're getting fatter so you cut back on either sugar or broccoli until in theory you don't get fatter these became products in the 1990s 21st century so these are heart healthy diet foods the way you know they're heart healthy or their diet foods is because they only have 100 calories each so they can't possibly make you fat because you can't eat too much of them 100 calories and they have 0 grams of fat 0 grams of saturated fat so they're they're good for your health ok they have 7 grams of sugar and 12 grams of sugar which doesn't sound like that much right but remember these are hundred calorie servings so that's 48% sugar it's a heart-healthy diet food that is almost 50% of the calories come from sugar this is what our diet Scott sir feeded with thanks to our guidelines to avoid saturated fat its products like this I'd like to think that only not very smart people ate them but I ate products like that when I was younger and I like to think I'm more than not very smart okay the other thing that changes since the 1980s it's insurance our diets change they got worse we had more sugar we ate less saturated fat weight less animal red and me we ate more white meat nina ty schultz has covered this wonderfully we began to understand the problem with locking in science when the evidence is premature is that the science evolves and the evidence evolved just like in a Crim case if you decide that you know who the killer is when you don't have sufficient evidence you stop looking elsewhere and you focus on proving that guys guilty instead of just with an unbiased eye collecting all the evidence to come to some decision so beginning in the nineteen eighties remember the science started in the 1960s with Yadkin there was a researcher at Stanford Gerald Reeve and endocrinologist who did critical research beginning in the early mid-1960s Rieman kept at it and eventually we came with this idea of metabolic syndrome and it evolved post 1980s after we had decided that dietary fat was a cause of heart disease because it calls raise cholesterol so a combination and medical disorders that increase the risk of developing cardiovascular disease and diabetes it affects 1 in 5 people prevalence increases with age here's the age specific prevalence you see by the time you get to be my age you've got a 50% chance of being obese and I'm having metabolic syndrome you know it's a cluster of 5 disorders we've talked about them all day to day low HDL high triglycerides high blood pressure expanded waist circumference what's the fifth and it's not part of it it's part of it but it's not part it's not officially part of it but didn't pardon me now it's eye blood pressure okay we got it we'll figure it out I mean small dense LDLs part but that's not that they consider it part what's interesting is when it arrived the insulin resistance and high insulin isn't a diagnostic criteria because the medical establishment thought it's too hard for physicians to measure insulin and in particularly in some resistance and a 15-minute doctor's appointment so it's never been called in summers it started its life as insulin resistance syndrome and what Gerald even called central max and then it became called metabolic syndrome and you have these other diagnostic criteria instead and the question is what causes metabolic syndrome and the convention of wisdom is sedentary behavior and maybe eating too much and the reason it's sedentary behavior instead of eating too much because lien people get metabolic syndrome and lien people by definition don't eat too much so we have to have another excuse for why they get it's a sedentary behavior a lot of the doctors who have become our allies became our allies because they were athletes who were lean who moved a lot and still got metabolic syndrome or pre-diabetes and had to figure out what to do about and what to do about it was not to eat carbs the biochemical wisdom for the cause of insulin resistance is sugar this combination of glucose and fructose what's interesting is the biochemists acknowledged this possibility and they have for 20 years now so Luc tapi is the leading fructose biochemist in the world he's at the University of Lausanne in 2010 he published this review article we said high fructose intake has indeed been shown to cause dis lipedema to impair hepatic insulin sensitivity although there's compelling evidence that very high fructose intake inability rias metabolic effects in humans and rodents the role of fructose and the development of the current epidemic of metabolic disorders remains controversial what's interesting is throughout this period so the the National Institutes of Health in United States wasn't funding research on meta mountain a dietary cause of metabolic syndrome because we knew what that was it was you know people get fat in their sedentary but there were researchers studying insulin resistance in metabolic syndrome that needed animal models of this disease particularly it stand for Gerald reven and they learned that it was very interesting to give animals insulin resistance metabolic syndrome if you fed them high fructose diets so something there researchers studying the effect of sugar on metabolic syndrome not because they're worried about sugar in our diets but because they want to be able to create metabolic servants it's syndrome in their laboratory animals so here are the potential mechanisms linking fructose induced insulin resistance to fructose to insulin resistance and it's you know everything we've been talking about in fact lipid Genesis this lipid emia increase in body fat it doesn't say liver fat but it might as well reactive oxygen species hyperuricemia which suggests hyper you know elevated uric acid levels are the galloped in effect and it suggests that sugar could be the cause of doubt if you believe the biochemistry and here's the link between fructose and actual chronic disease atherosclerosis high blood pressure vascular disease and the only thing I disagree with in this is tapi who wrote this believes that the way you get fat is you win have to eat too much so he includes this calorie intake where I believe that you could go straight from insulin resistance to obesity just by elevating and Sun in 2017 a team of researchers in the European Heart Journal basically published a review article explaining why every major organ in the body is influenced dilatory us by fructose and glucose by this combination of fructose being metabolized in the liver and causing insulin resistance and the glucose elevating insulin in association so the intestines the fat tissue the vasculature of the heart the kidneys in the brain ample clinical and biochemical biological evidence indicates that consumption of excess sugar promotes the development of cardio metabolic syndrome a fancier word for metabolic syndrome cardiovascular disease and type 2 diabetes so this has moved into consensus which is good I mentioned earlier I've been invited to speak at the Robert Wood Johnson Foundation and attend this symposium on Thursday I'm gonna be jet-lagged the reason they invited me it's not because they like what I've ever said about obesity despite the fact that they've spent a billion dollars trying and failing to curb the obesity epidemic in the United States it's because I wrote a book called the case against sugar so now I'm in their good graces because I can blame sugar instead of blaming the research establishment for missing the rest so there's one caveat well there's two caveats one is what do we mean by excess right because we don't know what excess means it's inherently a tautological concept and then the studies have never been done because the NI didn't fund the studies nobody really funds these sugar studies because a they're very difficult to do and B we know the causes of obesity and heart disease so the studies that exist are in animals and animals aren't humans the studies in humans tended to be a fructose alone and fructose alone is not sugar for a long time I used to have arguments with my allies saying you can't just blame fructose because we eat sugar and sugar has glucose in and the glucose stimulates insulin the insulin is metabolized in the context of that elevated insulin and elevated blood sugar and that changes what the liver does with it and studies tend to last a few weeks and we're looking at chronic effects that lasts that develop over years to decades and exactly zero long-term studies of the kind the NIH and the NIH spend close to a billion maybe two billion dollars testing the dietary fat hypothesis and failing to confirm it and zero of those long-term studies and what's interesting about those long-term studies we've talked about the problem with nutrition studies right they're hard to do you can't beat people on diets you're looking at chronic effects you need tens of thousands of people followed for a decade but the NIH will never fund this study in America because even if you could convince him of its rationale and you said look we want to get 20,000 people we're gonna rationalize to consume sugar at 20,000 people we are going to randomized to consume sugar and 20,000 not and we're gonna follow them for 20 years and they'll say why should we do this study everyone knows the people who don't eat sugar are gonna be healthier right I mean you couldn't get that funded in a gazillion years because the answer is obvious although they'll think they're gonna be healthier they won't know why they're healthier but they'll be convinced they're healthier if nothing else I'll need less dental work okay other caveats we discuss conclusion for the moment sugar may well be the fundamental cause of BC diabetes and heart disease B its effect on insulin resistance and saying as the Institute of Medicine has that there's a lack of scientific agreement or that it's controversial should not be reassuring the good thing about this is since I put this talk together a year ago people don't care that the science isn't nailed down they've decided we can go after sugar and they're doing it so nobody really none of the government authorities don't really talk about this as being controversial so here's the very last issue I assume you guys have dr. Seuss Down Under it's what my wife calls the Grinch issue okay if you're getting fat or you know it if you're getting diabetic you eventually learn it so you could in a sense fix your diet in time but that's not what happens with cancer so if sugar has any link to cancer you're just kind of screwed and you hope that whatever cancer you get is treatable so remember this well I didn't show this diagram earlier or the one like it obesity is associated with the whole host of chronic diseases again the message we've been talking about throughout this day so not just in some resistance and type-2 diabetes but fatty liver heart disease hypertension stroke cancer so in populations and in individuals obesity and diabetes and insulin resistance associates with an elevated risk of cancer here's how the food nutrition physical activity and reporting the prevention of cancer put in 2007 linking obesity insulin resistance insulin like growth factor all elevated and obese people they can all promote the growth of cancer cells in addition insulin resistance is increased in particular by abdominal fatness I don't know if that cause and effect is correct and the pancreas compensates by increasing insulin production the hyperinsulinemia increases the risk of cancers of the colon endometrium and possibly the pancreas and kidney this is how it looks and a Nature Reviews cancer article so insulin resistance elevates insulin if your elevated insulin you've got you up regulate the insulin receptor on cancer cells you up regulate the insulin like growth factor receptor you make more in someone like growth factor which is a growth factor for tumor cells biologically and available and you increase the risk of tumor development you accelerate tumor development so insulin resistance is basically a carcinogenic condition as our elevated blood sugar and there's an arrow at the top of that screen because the question is what causes insulin resistance so the conventional wisdom by the way is sedentary behavior remember so you guys are engaged in carcinogenic behavior right now which I actually find hard to believe if it's fructose if it's sugar this combination of fructose and sucrose and it's carcinogenic so whatever causes in some resistant to at least increase the risk of cancer thank you [Applause]

Channel: Low Carb Down Under

Views: 121,665

Keywords: Low Carb Down Under, LCDU, www.lowcarbdownunder.com.au, Low Carb Gold Coast 2019, #LowCarbGC, Why We Get Fat, NUSI, Good Calories, Bad Calories, Insulin Resistance, Big Sugar, Fructose, Sucrose, Obesity, Chronic Disease, Diabetes, Metabolic Syndrome, LCHF, Ketogenic Diet, Blood Glucose

Id: E0QvRreX7Gk

Length: 58min 20sec (3500 seconds)

Published: Sat Jan 11 2020

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The Case Against Sugar | Gary Taubes | download https://b-ok.cc/book/2850733/02bf19