Is our ‘fear’ of sugar unfounded?
It depends. I’d say in rational, health-conscious, physically active adults, the fear of sugar is indeed unfounded. In children and adolescents (who are mostly clueless about health, lets’ face it), sugar consumption is often unbridled & combined with physical inactivity, so yeah – the concern is there. The crux of sugarphobia centers around fructose, which is an almost unavoidable component of commercially available sugar-sweetened products. Table sugar itself (sucrose) is half glucose, half fructose, and high-fructose corn syrup (HFCS) which is ubiquitous in soft drinks and packaged sweets has a slightly but inconsequentially higher proportion of fructose. Many are familiar with Robert Lustig’s campaign against sugar, and his emphasis on the evils of fructose. What often fails to be addressed is that dose and context make all the difference in the world. The research indicting fructose as an inherent agent of harm uses artificially high doses that are many times greater than typical human intakes. Much of this research is rodent-based, and rodents’ capacity to convert dietary carbohydrate to fat is roughly ten-fold that of humans. There are several diligent scientific reviews that have been done on this topic, which I would encourage everyone to read, since the full text is publicly available. To quote a recent review by Salwa Rizkalla:
“Despite the epidemiological parallel between the marked increase of obesity and fructose consumption, there is no direct evidence linking obesity to the consumption of physiological amounts of fructose in humans (≤ 100g/day). A moderate dose (≤ 50g/day) of added fructose has no deleterious effect on fasting and postprandial triglycerides, glucose control and insulin resistance.”
I would also encourage everyone to read John White’s recent review challenging the fructose hypothesis, whose key points are quoteworthy:
“In considering the volume of contemporary literature on fructose, 1 conclusion stands clear: fructose is safe at typical intake levels but can produce adverse metabolic effects when abused—as is true of most nutrients. It turns out that the largest abusers of fructose are not American consumers, but research scientists. [...] It is only when researchers hyperdose human and animal subjects with fructose in amounts that exceed the 95th percentile by 1.5- to 3- and 4- to 5-fold, respectively, that adverse effects are provoked.”
The way I see it, the practical take-away for the general population would be to keep added sugar (as opposed to intrinsic sugar in milk or whole fruit) limited to roughly 10% of total calories. This will allow for moderation & sane dietary practices while also hedging your bets away from the adverse potential of excess intake. Certain athletes involved in high-volume endurance competition (and other highly physically active folks) can safely exceed this in order to meet the demands of their sport.
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