The study authors came to the conclusion that sugar is toxic and that it is the cause of the “diabetic epidemic” in affluent countries after controlling for several other factors that have been implicated or suspected to be involved in the upsurge of type 2 diabetes in Western societies.
The researchers found a strong link between increased sugar availability in populations and rates of diabetes independent of rates of obesity. The New York Times emphasizes that the study demonstrated the correlation with a level of confidence similar to that which linked cigarettes and lung cancer in the 1960s
According to The New York Times, one of the study authors, Robert Lustig, pediatric endocrinologist at the University of California, San Francisco, said: “You could not enact a real-world study that would be more conclusive than this one.”
The study controlled for poverty, urbanization, ageing, obesity and physical activity, It controlled for other types of foods consumed including fibers, meats, fruits, oils, cereals. It also controlled for total calories and “period-effects.”
According to The New York Times:
In short, it controlled for everything controllable and it satisfied the longstanding “Bradford Hill” criteria for what is called medical inference of causation by linking dose (the more sugar available, the more the occurrences of diabetes); duration (if sugar is available longer, the prevalence of diabetes increased); directionality (not only does diabetes increase with more sugar, it decreases with less sugar); and precedence (diabetics don’t start consuming more sugar; people who consume more sugar are more likely to become diabetics).
According to the study abstract:
Using econometric models of repeated cross-sectional data on diabetes and nutritional components of food from 175 countries, we found that every 150 kcal/person/day increase in sugar availability (about one can of soda/day) was associated with increased diabetes prevalence by 1.1% (p <0.001) after testing for potential selection biases and controlling for other food types (including fibers, meats, fruits, oils, cereals), total calories, overweight and obesity, period-effects, and several socioeconomic variables such as aging, urbanization and income. No other food types yielded significant individual associations with diabetes prevalence after controlling for obesity and other confounders. The impact of sugar on diabetes was independent of sedentary behavior and alcohol use, and the effect was modified but not confounded by obesity or overweight. Duration and degree of sugar exposure correlated significantly with diabetes prevalence in a dose-dependent manner, while declines in sugar exposure correlated with significant subsequent declines in diabetes rates independently of other socioeconomic, dietary and obesity prevalence changes. Differences in sugar availability statistically explain variations in diabetes prevalence rates at a population level that are not explained by physical activity, overweight or obesity.
That is, for every 12 ounces of sugar-sweetened beverage “introduced per person per day into a country’s food system, the rate of diabetes goes up 1 percent.”
The Telegraph reports a previous commentary based on emerging statistical trends in the journal Nature, that sugar poses a massive health risk contributing to an estimated 35 million deaths around the world annually. The researchers said that based on the evidence, sugar should be considered a potentially toxic substance like alcohol and tobacco.
According to the researchers, the evidence linking sugar consumption to the onset of type 2 diabetes is such that a tax should be imposed on all foods and drinks that contain “added” sugar. The researchers also recommended banning sales of foods and drinks with “added” sugar in or near schools, and placing age limits on the sale of sugar “added” products.
However, those advocating punitive measures to curb the consumption of sugar say they are expecting resistance from the promoters of sugar consumption “just as tobacco companies fought, ignored, lied and obfuscated in the ’60s (and, indeed, through the ’90s).”
But according to The New York Times, Lustig, concluding from the study result, said: “This study is proof enough that sugar is toxic. Now it’s time to do something about it.”
The Telegraph notes that experts say that what is most toxic in sugar is sucrose, a naturally occurring compound consisting of glucose and fructose used in making table sugar and a processed sugar called “high-fructose corn syrup.”
Both products are used widely in the food processing industry, added to “cereals, breakfast bars, some meats, yogurts, soups and sauces.”
Added sugar is dangerous to health particularly because its fructose content is broken down in the liver and thus puts a strain on the vital organ leading to diet-related conditions such as fatty liver and liver failure. But significant is the discovery that it triggers type 2 diabetes by forcing the pancreas to produce large amounts of insulin which helps to keep blood sugar levels within safe limits.
Over time the pancreas begins to fail under stress and the body cells become increasingly resistant to the effects of insulin, causing blood sugar levels to remain high. This leads to damaging effects, especially on the cardiovascular system the several other organs of the body including the kidneys, peripheral nerves and the visual organs.
According to The New York times, type 2 diabetes has reached epidemic proportions in Western countries. In the UK, there are 2.6 million people diagnosed with the illness and an estimated 1 million not diagnosed. The cost to the health service is estimated at 10 per cent of the NHS budget. The cost of diabetes globally is estimated at $465 billion a year.