This article will barbecue one major sacred cow: sugar. If you’re of the mindset of “I believe sugar is the devil, evidence be damned, and nothing you can say/no research you can show me that will change my mind”, do yourself a favour – close this page now.
However, if you believe that sugar is bad for you, but are open-minded enough to dive into the nuances of when it is actually bad for you, and when it isn’t, this is the article for you. I realize that after decades of indoctrination that “sugar is the devil”, it might be hard to see the truth. However, for this article, I brought my receipts – scientific evidence.
Myth #1: Sugar is Inflammatory
Actually, it isn’t. Excess sugar is inflammatory. And it’s not because of the sugar – it’s because of the calories. Excess calories are inflammatory, regardless of where the calories come from. If you get excess calories from dietary fat, then dietary fat is inflammatory.
In my inflammation book, I show how one meta-analysis evaluated 13 studies. The studies compared 4 different sugars against each other: fructose, glucose, sucrose (that’s table sugar) and “the devil” – high fructose corn syrup. When the diet made people gain weight, sugar increased inflammation. When the diet didn’t make people gain weight, none of the sugars increased inflammation (even though the sugar doses were often 50-100 grams/day, which is quite high). This is true for all inflammatory markers studied: hsCRP, IL-6 and TNF-α.
So is it really sugar that causes inflammation, or just excess calories? Well, if you eat 50-100 grams of sugar per day within your caloric limit, it’s not inflammatory. If you eat that same amount of sugar, but it’s above your caloric limit, it is inflammatory. So it’s really not sugar that’s inflammatory. It’s excess calories that are inflammatory.
Yes, sugar is delicious, and it often causes us to eat beyond just hunger – in that case, it’ll increase inflammation. But there are also those people who can just have a small piece of chocolate, and be done. To call sugar inflammatory no matter what isn’t accurate.
Another meta-analysis looked at sugar from different sources.
- Soft drinks didn’t increase any inflammatory markers, as long as people didn’t gain weight.
- 100% fruit juices lowered hsCRP by an average of 1.09, as long as people didn’t gain weight.
- Dark chocolate actually lowered IL-6 by 8.79 pg/mL.
Another case when sugar is indeed inflammatory is in diabetics. In one study, diabetics and non-diabetics were fed the same amount of sugar. In the diabetics, sugar was inflammatory. In non-diabetics, it wasn’t. Speaking of diabetics, that brings me to another myth about sugar…
Myth #2: Sugar Causes Diabetes
On the surface, you would think that by eating sugar, you raise your blood sugar to the point that you get diabetes. Perfectly logical, but not correct.
As I explain in my diabetes book, in a healthy person, when you eat sugar, your pancreas releases insulin and brings blood sugar down to normal levels. No problem.
Also, when the sugar you consume is within your caloric limits, it’s not as big of a problem, either. This is not just my opinion. One study concluded “excess sugar can promote weight gain, thus T2DM [my note: T2DM stands for “type 2 diabetes mellitus”], through extra calories, but has no unique diabetogenic effect at physiological levels.”
In another study, researchers divided participants into 2 groups:
- Group 1: was given sugar.
- Group 2: was given an equivalent amount of calories as group 1, but in bread.
During and after that meal, there was no difference in the blood sugar levels between the 2 groups.
And there are many more studies like this, basically showing that dietary sugar does not have special diabetes-causing chemistry. Sugar is only responsible for diabetes in its ability to add excess calories to the diet.
I can hear some readers thinking “but wait – what about all the studies saying that sugar is correlated to diabetes?” Sure, sugar is correlated to diabetes, but it doesn’t mean it causes diabetes. Sunscreen sales are correlated to drowning, but it doesn’t mean that sunscreen causes drowning. It’s quite simple – the higher the temperature, the more people buy sunscreen. And the higher the temperature, the more people go swimming. Same with sugar – higher sugar is correlated to diabetes. And higher calories are correlated to diabetes. But it doesn’t mean that sugar in and of itself causes diabetes. Remember – correlation is not causation.
Don’t get me wrong – sugar isn’t exactly good for diabetics (or non-diabetics for that matter). But to blame it for diabetes isn’t accurate, either.
Myth #3: Sugar Increases Body Fat
Incorrect. I know, I know – so far, I’ve exonerated sugar from inflammation and diabetes, but we have to find something that it’s bad for. Let’s go with body fat. Too bad that the scientific evidence doesn’t back it up.
In one study, researchers divided participants into 2 groups: one group ate a low sugar diet (10% of daily calories), and one group ate a high sugar diet (25% of daily calories). But both groups had the same number of calories. Just the composition of those calories was different. After 6 weeks on this diet, there was no change in weight between the high sugar group, and the low sugar group.
Another study found the same thing: that as long as calories are the same, there was no difference in weight between people who ate a lot of sugar or a little sugar.
So it’s really not sugar that causes fat gain. It’s excess calories. If those excess calories come from sugar, that’ll cause fat gain. If you have a lot of sugar, but it’s within your caloric limits, it won’t cause fat gain.
When is Sugar Bad?
So far, we’ve shown when sugar is neutral. It’s not the devil it’s been made out to be. But it’s not exactly a health food, either.
One case when it’s actually just slightly bad is in people who have pre-existing high cholesterol. As I talk about in my cholesterol book, in one meta-analysis, when sugary drinks were removed from the diets of dyslipidemic people, their triglycerides decreased by 10-20%, LDL-C decreased by 5-10%, and HDL-C increased by 5-10%.
So yeah, cutting sugar has a small positive impact on cholesterol profiles – just not enough to consider it a nutritional hero. However, if someone does eat sugar, and they want to keep eating sugar, there are 4 other nutritional strategies I talk about in my cholesterol book that can improve cholesterol profiles without removing sugar. The benefits of eating “good stuff” outweigh the drawbacks of eating the “bad stuff.”
Why is Sugar to Blame?
So if scientific evidence shows that sugar is mostly neutral, and in just a few cases, slightly harmful, why are its negative effects blown so far out of proportion? A bunch of reasons:
- Many studies are done in mice or rats. But a very basic principle of science is that you can only generalize based on the population studied. You can generalize from mice to other mice. But you can’t generalize from mice to people.
- Many studies correlate sugar to bad health outcomes. But you’re a reader of my newsletter – you’re savvier than the average person. You know that correlation isn’t causation. You can’t make any cause-and-effect conclusions based on observational research. To infer cause-and-effect, you have to have interventional research (randomized controlled trials). And the randomized controlled trials that I’ve shown you in this article show that sugar is somewhere between neutral and mildly harmful.
- It’s trendy to blame sugar. Very few people read the research. They rely on others. It’s a long chain of broken telephone. This ends in a scenario where the blind are leading the blind.
- Sugar tastes good. If it tastes good it can’t be good for you. Yeah, sometimes, the thinking is that simple.
Sugar in Context
Now we know that sugar isn’t the devil. Most of the time, it’s neutral – not harmful, not beneficial. In a few cases, it’s just mildly harmful, and you can easily overcome those mild harms with some easy nutritional strategies (the simplest one being to just pair a sugary snack/meal with fibre).
Nutritionally, there are no benefits to sugar, and there’s no dietary requirement for it. So no, you’re not doing anything wrong by cutting it out. But if you do choose to include it, just know that it won’t kill you, it won’t give you diabetes, and it won’t raise your car insurance rates.
