Sugar and artificial sugar: are they poisonous?

Yesterday some of you may have noticed an article about sugar potentially being a poison in The New York Times. So why is it, you might ask, that I get to write an editorial about it? Because it's my blog and I must be one of the only people in the world who is actually angered by this article. And WHY am I angry, you ask. Because sure, sugar is not the healthiest thing one can eat, but implicating that is a "poison" responsible for the obesity-related health problems in the US is ignoring the real issue.

Educated people in the US (and Denmark), (aka, those people who like what white people like, yeah yeah I've been know to be guilty of this, too) love blaming problems on dietary imbalances and finding fads to turn life around. This will anger over half of my readers, but I am thinking along the lines of the paleo diet and gluten intolerance.

Bare with me (edit: SR just pointed it, I should only use "bare" with me when talking to him and otherwise it's the animal, "bear". It always confuses me!). Sugar is not a poison. But when people sit around all day without exercise and eat foods with added sugar or, even worse, high fructose corn syrup, they get fat and thus develop health problems. No one is denying that. But the real problem is life-style. Sugar is just not very filling, so when people eat it, they tend to simply want to eat more because they don't get full and the problem is exacerbated. But let's take someone who exercises. For example, SR. He has exercise as a part of his daily routine, plus when he works out, it is fairly intense. He eats sugar (candy) constantly! It disgusts me since I know it would make me feel like crap, but will he develop diabetes or heart disease from it? No. Because both exercise and our muscles (yes our muscles are also glands!) keep our blood sugar regulation so amazingly finely tuned that eating a lot of sugar really has no effect other than making you feel kind of tired and crappy. Contrast this with smoking, which truly is toxic at the cellular level. Sugar is simply not toxic. But it can make you fat.

There are people out there who try to blame our society's health problems on fructose (The Healthy Skeptic comes to mind, who I have had angry words with on a few occassions). This is turn leads educated people to do things like not eat fruit because it has fructose in it and thus feel themselves superior to others. Well, guess what? Fruit is healthy! And then bread. Poor bread. There is nothing wrong with bread as long as it is eaten as part of a balanced diet and as long as one is physically active.

I am so frightened of what will happen to Natti and The Lorax and Finnbjørn when we move to the US. They will be forced into that sedentary American lifestyle and suffer for it. I have already told SR my plan of the morning boot camp where the kids and I go out running an hour before school just so they can survive America.

Scientists, educated people, health care workers, I appeal to you, stop blaming sugar and bread for health problems in our society and take a look at the bigger problem which is the sedentary lifestyle. Get off of your high paleolithic horses and get real.

Paleolithic Horse at the Caves of Lascaux.



Ahhh. That felt good.

Edit: As long as we're talking about all things Paleolithic: what is the big difference between now and the Paleolithic Era? The size of the human population. The total population now (6.91 billion) is approximately 1,382 times what it was during the Paleolithic era (5 million)! And why is that? The farming of grains! Yay grain. Does anyone who adheres to The Paleolithic Diet honestly believe it is sustainable at a worldwide level??? No way! It is a HUGE use of resources for people in developed countries to eat Paleolithically. Shouldn't a diet both be healhty and sustainable?

Now, onto diet soda. Or should I call it artificial sweeteners? What I want to talk about is a study that was in the American Journal of Clinical Nutrition last June. It was a large Danish study that was actually very well-written. It found that the more diet soda a woman drank, the more likely she was to give birth prematurely. In fact, if a woman drank 4 or more diet sodas a day, her odds of premature birth was increased by 1.86. This is more than if a woman smokes. Amazing, really. And scary for a mom-to-be who likes diet soda. Plus this is just the kind of study the media would L-O-V-E. But what is the catch? Why do I even mention this? Because they played with their data to get a significant result. And if one considers how a study like this could play with a pregnant woman's psyche, it is sickening that the authors would do this to get published. But, as a researcher myself, I know how tempting rationalizations can be, and I am hesitant to blame them, per se. But here were the ingredients of their "fudge":

1. They reported their results in odds ratios rather than relative risk. When looking a prospective cohort, one should report in relative risk unless the expected outcome is exceedingly rare. There is around a 12% chance of premature birth in the developed world, which is not exceedingly rare, so they obviously did this to make their results significant.

2. They broke their analyses up into subgroups when the results weren't significant in the large group: They considered diet soda and other diet beverages two separate things even though they mostly are both sweetened with aspartame. They only did this because all artificially sweetened beverages taken together did not have an effect on premature birth.

3. Just like in the case of sugar, they do not fully address the real problem - socioeconomic class. If there is one meaningful risk factor that has been found for premature birth, it is that. Take a look at this graph, bearing in mind that there is NO increased risk for premature birth in Africa compared with the US (ie it is not genetic).



This is a graph from the CDC. It shows percentage of "late" premature births by race and that is why the "all births" line is only just over 6% and not the 12%, which I quoted above for all premature births.

The New England Journal's review article on "the enigma" of premature birth summed it up best: "Numerous epidemiologic studies have shown the association of poverty, limited maternal education, young maternal age, unmarried status, and inadequate prenatal care with increased risk of preterm birth and low birth weight."

And women who drink more than four glasses of diet soda a day had exactly these characteristics, when they broke down their data, though they failed to control for everything associated with low socioeconomic class and how could they? They have thus not proven causation between diet soda and premature birth (and couldn't with this study design anyway), but have simply shown that drinking excess diet soda goes along with low socioeconomic class, at least in Denmark. Maybe there is something toxic in aspartame, but if there is it is VERY mildly toxic, as they had a huge study and were unable to show a link with all groups of aspartame-sweetened drinks taken together. If anything, they have proven that aspartame is, in fact, not very toxic.

What about me personally? Well, funny thing is, just because of how they taste and make me feel, I've cut down a lot on both refined sugar and artificially sweetened products since getting pregnant. And I have to admit I feel better for it. But when considering the of effects sugar, I am simply saying: be realistic and ---take it with a grain of salt!

Running song of the day: An oldie but a goodie: Cigarettes and Red Vines by Aimee Mann (you tell me which one is the toxin)